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Concise Summary: Maine is requesting to renew the Maine HIV/AIDS Section 1115 Demonstration Waiver under the Social Security Act effective January 1, 2014. The objective of this waiver is to provide more effective and earlier treatment, improve access to continuous health care, provide a comprehensive package of services to people living with HIV/AIDS, to assist in enhancing compliance with treatment and medication regiments, and to meet cost-effectiveness as required by federal regulations. The key feature of this waiver which allows for the objectives to be successfully accomplished is the care management services. Maine is not anticipating any impact on enrollment or spending unless a Medicaid expansion occurs. If so, some enrollees would move from the waiver to full MaineCare benefits.
Maine does not anticipate asking for any substantial modifications to the existing Section 1115 Demonstration waiver. Maine has continued to make improvements with care management and cost saving initiatives. Member satisfaction rates with the program have continued to increase. In 2009 our annual member satisfaction survey showed the satisfaction rate had increased to approximately 78% and in 2011 the satisfaction rate had increased to approximately 84%. The waiting list has not been utilized during State Fiscal Year 12 for this project, as the cost of patient care is not projected to exceed the project allotment. However, the State may institute a cap in the future should budget estimates indicate costs will exceed the project allotment.
Members are eligible for transportation services under a 1915(b) waiver. Transportation Services are provided to enable members to gain access to waiver services. The transportation services are available only through the MaineCare Benefits Manual, Chapter II, Section 113 (Transportation Services). Chapter X, Section I waiver providers are not reimbursed for transportation services provided to waiver members. Transportation services under the waiver are provided in accordance with the member’s Waiver Service Plan. Whenever possible, family, neighbors, friends, or community agencies who can provide transportation services without charge, must be utilized
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