Emergency News CHAPTER NUMBER AND TITLE: MaineCare Benefits Manual, Chapters II & III Section 91, Health Home Services

January 29, 2013

EMERGENCY RULES

CHAPTER NUMBER AND TITLE: MaineCare Benefits Manual, Chapters II & III Section 91, Health Home Services

CONCISE SUMMARY: Effective January 1, 2013, the Department will offer and reimburse Health Home Services under a new section of policy, Chapters II and III, Section 91. Health Home Practices will be reimbursed at a rate of $12.00 per member per month and Community Care Teams will be reimbursed at a rate of $129.50 per member per month under this section of policy, if they meet the standards of Section 91. This new MaineCare service will be offered to eligible MaineCare members who have been diagnosed with two chronic conditions, or who have one chronic condition and are at risk for another chronic condition. Under a Plan of Care, members will receive all or some of the following services: Comprehensive Care Management, Care Coordination, Health Promotion, Comprehensive Transitional Care, Individual and Family Support Services, and Referral to Community and Social Support Services. These services are unique and will not duplicate other MaineCare services. The DHHS will be seeking CMS approval of the State Plan for these changes.

See ">http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.

EFFECTIVE DATE: January 1, 2013

AGENCY CONTACT PERSON: Derrick Grant, Health Planner AGENCY NAME: Division of Policy and Performance ADDRESS: 242 State Street 11 State House Station Augusta, Maine 04333-0011 TELEPHONE: (207)-287-6427 FAX: (207) 287-9369 TTY: 711 (Deaf/Hard of Hearing)