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May 5, 2004
as posted
in 5 daily Maine newspapers
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NOTICE OF STATE RULE-MAKING
Public Input for Proposed and Adopted Rules
Notices are published
each Wednesday to alert the public regarding state agency rule-making.
You may obtain a copy of any rule by notifying the agency contact person.
You may also comment on the rule, and/or attend the public hearing.
If no hearing is scheduled, you may request one -- the agency may then
schedule a hearing, and must do so if 5 or more persons request it.
If you are disabled or need special services to attend a hearing, please
notify the agency contact person at least 7 days prior to it. Petitions:
you can petition an agency to adopt, amend, or repeal any rule; the
agency must provide you with petition forms, and must respond to your
petition within 60 days. The agency must enter rule-making if the petition
is signed by 150 or more registered voters, and may begin rule-making
if there are fewer. You can also petition the Legislature to review
a rule; the Executive Director of the Legislative Council (115 State
House Station, Augusta, ME 04333, phone 207/287-1615) will provide you
with the necessary petition forms. The appropriate legislative committee
will review a rule upon receipt of a petition from 100 or more registered
voters, or from "...any person who may be directly, substantially and
adversely affected by the application of a rule..." (Title 5 Section
11112). World-Wide Web: Copies of the weekly notices and the full texts
of adopted rule chapters may be found on the World-Wide Web at: http://www.maine.gov/sos/cec/rcn/apa/.
PROPOSALS
AGENCY:
01-015 - Maine Milk Commission
RULE TITLE OR SUBJECT: Ch. 3, Schedule of Minimum Prices - Order
#06-04
PROPOSED RULE NUMBER: 2004-P111
CONCISE SUMMARY: The Maine Milk Commission will set minimum prices for
Class I, II, III and Butterfat based on Federal Order #1 prices with
prevailing premiums and other factors that may be presented.
THIS RULE WILL NOT HAVE A FISCAL IMPACT ON MUNICIPALITIES.
STATUTORY AUTHORITY: 7 MRSA §2954 & 5 MRSA §8054
PUBLIC HEARING: 1:30 p.m. Friday, May 21, 2004, Room 233, Department
of Agriculture - Deering Building, Hospital Street, Augusta, Maine 04333
DEADLINE FOR COMMENTS: May 21, 2004
NAME: Stanley K. Millay, Executive Director
ADDRESS: Maine Milk Commission, Deering Building-Station #28, Augusta,
Maine 04333
TELEPHONE: (207) 287-3741
AGENCY:
10-144 - Department of Human Services, Bureau of Medical Services
RULE TITLE OR SUBJECT: Ch. 101, MaineCare Benefits Manual: Ch.
II and III Section 6, Assisted Living Services.
PROPOSED RULE NUMBER: 2004-P112
CONCISE SUMMARY: These proposed rules establish assisted living services
under the MaineCare Benefits Manual for members who reside in Assisted
Living Programs licensed by and under contract with the Department.
Members will receive assisted living services including assistance with
activities of daily living, incidental household tasks, medication supervision,
personal supervision, and care management. Members will be assessed
for level of need for assistance using the MDS-ALS assessment tool.
The Department will reimburse Assisted Living Programs for services
provided to members under the program based on a resource-adjusted price
and program allowance established on a prospective basis.
THIS RULE WILL NOT HAVE A FISCAL IMPACT ON MUNICIPALITIES.
STATUTORY AUTHORITY: 22 MRSA §42, §3173
PUBLIC HEARING:
Date: May 26, 2004, 1:30 p.m.
Location: Department of Human Services, 442 Civic Center Drive, Augusta,
Maine. Any interested party requiring special arrangements to attend
the hearing must contact the agency person listed below before May 20,
2004.
DEADLINE FOR COMMENTS: June 6, 2004
AGENCY CONTACT PERSON: Patricia Dushuttle, Comprehensive Health Planner
AGENCY NAME: Bureau of Medical Services, Policy and Provider Services
ADDRESS: 442 Civic Center Drive, 11 State House Station, Augusta, Maine
04333-0011
TELEPHONE: (207) 287-9362
FAX: (207) 287-9369
TTY: (800) 423-4331 or (207) 287-1828 (Deaf or Hard of Hearing)
ADOPTIONS
AGENCY:
13-188 - Department of Marine Resources
CHAPTER NUMBER AND TITLE:
Ch. 25.07, ASMFC Lobster Management Areas and Limitations (new),
and
Ch. 25.08(B)(2), Lobster Trap Tag System
ADOPTED RULE NUMBER: 2004-129
CONCISE SUMMARY: The regulations on limitations for lobster management
areas (LMA's) for compliance with the Atlantic States Marine Fisheries
Commission (ASMFC) Interstate Fishery Management Plan (FMP) for American
lobster are adopted. The ASMFC has approved a variety of area-by-area
management measures, which include but are not limited to minimum/maximum
gauge sizes, escape vent sizes, v-notch definitions, and trap limits.
The FMP requires that all states implement and enforce the management
measures in the areas under their jurisdiction. Persons holding a Maine
lobster/crab fishing license and a federal lobster permit who
select multiple LMA's are required to follow the most restrictive management
measures for all LMA's declared. For persons who do not hold
a federal lobster permit but do hold a Maine lobster/crab fishing license,
the ASMFC FMP for American lobster requires lobster management area
1 to be added to trap tags.
CHAPTER NUMBER AND TITLE: Ch. 9, Harvester: Shellstock Harvesting,
Handling and Sanitation (New), and
Repeal of Ch. 48, Identification and Tagging of Shellfish
ADOPTED RULE NUMBER: 2004-130
CONCISE SUMMARY: The adopted regulations for new Ch. 9 provide a single
consolidated chapter of shellfish sanitation rules that apply only to
shellfish harvesters, by separating the rules that apply to harvesters
from the rules that apply to certified shellfish dealers, which have
been updated in Ch. 15-20. This rulemaking updates the rules consistent
with the National Shellfish Sanitation Program Model Ordinance under
the federal U.S. Food and Drug Administration, and is concurrent with
separate rulemaking adoptions in Ch. 15-20.
CHAPTER NUMBER AND TITLE: Ch. 11.07(l)(a)(iii), Configuration
of Drag - Technical correction
ADOPTED RULE NUMBER: 2004-131
CONCISE SUMMARY: The amended regulation will allow slight variations
in small drags (3.5 feet or less in width) in accordance with Ch. 11.07(l)(a)(iii)
by allowing design changes on a case-by-case basis when approved by
permit from the Commissioner.
CHAPTER NUMBER AND TITLE:
Ch. 15, General Shellfish Sanitation Requirements
Ch. 16, Uniform Physical Plant Equipment and Operation Requirements
Ch. 17, Shucker-Packer
Ch. 18, Shellstock Shipper
Ch. 19, Reshipper
Ch. 20, Depuration
ADOPTED RULE NUMBER: 2004-132 through 2004-137
CONCISE SUMMARY: Parallel rulemakings are adopted in each of Ch. 9 and
15-20 on shellfish sanitation regulations to update these regulations
with the U.S. Food and Drug Administration's National Shellfish Sanitation
Program - Model Ordinance. These regulations update the general overall
sanitation rules for certified shellfish dealers for federal compliance
and consistency.
CHAPTER NUMBER AND TITLE: Ch. 31.10(C), Horseshoe Crabs - Daily
and Possession limits
ADOPTED RULE NUMBER: 2004-138
CONCISE SUMMARY: These adopted regulations prohibit the taking or possession
of horseshoe crabs during the months of May through October to prevent
depletion of this species in Maine waters, which is at relatively low
levels of abundance compared to horseshoe crab stocks in waters south
of New England. Current rules that allow possession of horseshoe crabs
lawfully imported into Maine from other jurisdictions have not changed.
CHAPTER NUMBER AND TITLE: Ch. 37, Freshwater Fish Regulations:
Ch. 37.02, Minimum Length Limit for Landlocked Salmon, Brown
Trout, and Rainbow Trout
ADOPTED RULE NUMBER: 2004-139
CONCISE SUMMARY: This adopted regulation establishes a maximum length
limit on landlocked salmon of 25 inches in Maine's coastal waters. This
measure provides increased protection to sea run Atlantic salmon because
small sea run salmon could be mistaken for landlocked salmon and retained
by anglers. Most landlocked salmon in Maine estuarial waters do not
exceed 25 inches in total length while the smallest sea run salmon exceed
25 inches total length. The 25-inch maximum size limit for landlocked
salmon will assure that sea run salmon are not accidentally retained
as landlocked salmon, which would contribute to mortality of the scarce
sea run salmon stocks.
CHAPTER NUMBER AND TITLE: Ch. 55.03, Special Area Closures to
Finfishing
ADOPTED RULE NUMBER: 2004-140
CONCISE SUMMARY: This adopted regulation closes the waters within 75
feet of any part of the fishway located at Damariscotta Mills in addition
to the existing 150-foot closure from the dam at this location. Under
current rules the mouth and portions of the fishway, at this particular
location, are more than 150 feet from the dam, which has been an unintended
circumstance that allows persons to fish within the fishway. The 75-foot
restriction is consistent with the Department of Inland Fisheries and
Wildlife special closures around fishways in fresh water.
CHAPTER NUMBER AND TITLE:
Ch. 110, Marine Harvesting Demonstration License (New), and
Ch. 25.08(B)(1)&(6), Lobster Trap Tag System
ADOPTED RULE NUMBER: 2004-141
CONCISE SUMMARY: These adopted regulations finalize the requirements
for a marine harvesting demonstration license in accordance with 12
MRSA §6810-A(9), which became effective on January 1, 2004. The authorizing
statute is available from: http://www.maine.gov/dmr/bmp/lawindex/6810-A.htm.
The regulations limit the method of lobster harvesting pursuant to a
marine harvesting demonstration license to lobster trap hauling; require
tagging of up to a maximum of 20 lobster traps; require vessel and buoy
marking; require vessel and zone declaration on the license application;
and require liberation alive of all specimens collected immediately
following a harvest demonstration. These regulations allow the take
and possession of marine organisms with the restriction that no lobster
be taken by diver; and limit the number of marine specimens captured
by diver for demonstration purposes.
EFFECTIVE DATE: April 27, 2004
AGENCY CONTACT PERSON: Laurice U. Churchill
AGENCY NAME: Department of Marine Resources
ADDRESS: PO Box 8, West Boothbay Harbor, Maine 04675-0008
WEB SITE: www.maine.gov/dmr/rulemaking/
TELEPHONE: (207) 633-9584
FAX: (207) 633-9579
TTY: (207) 633-9600 or 287-4474 (Deaf/Hard of Hearing)
AGENCY:
10-144 - Department of Human Services, Bureau of Medical Services
CHAPTER NUMBER AND TITLE: Final rule, Ch. 101, MaineCare Benefits
Manual: Ch. II Section 95, Podiatric Services.
ADOPTED RULE NUMBER: 2004-142
CONCISE SUMMARY: The final rule permanently adopts emergency rule changes
in effect from 2/3/04 to 5/2/04 which clarified the definition of routine
podiatric care, covered routine podiatric care; limited frequency of
routine podiatric care without prior authorization; required prior authorization
for all bunion surgery; updated definitions for routine podiatric care;
and added new text describing non-covered services. In addition, the
final rule: repeals Ch. III for Section 95, Podiatric Services, with
billing to be in accordance with procedures outlined in applicable sections
of Ch. II and III, Section 90, Physician Services; updates definitions
for podiatric services; deletes obsolete references for member eligibility;
includes new language for covered services and references for coverage
of supplies and materials for non-routine purposes; and deletes obsolete
text regarding policies and procedures, copayment, and billing instructions
with references to Ch. I, General Administrative Policies and Procedures.
Lastly, the rule updates terminology throughout Ch. II, Section 95.
See http://www.maine.gov/bms/rulemaking/
for rules and related rulemaking documents.
EFFECTIVE DATE: May 3, 2004
AGENCY CONTACT PERSON: Peter J. Ezzy, Medical Care Administrator
AGENCY NAME: Bureau of Medical Services, 11 State House Station, Augusta,
ME 04333-0011
TELEPHONE: (207) 287-9368
FAX: (207) 287-9369
TTY: (800) 423-4331 or (207) 287-1828 (Deaf/Hard of Hearing)
AGENCY:
10-144 - Department of Human Services, Bureau of Medical Services
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual:
Ch. III Section 102, Rehabilitative Services
ADOPTED RULE NUMBER: 2004-143
CONCISE SUMMARY: Procedure code Z9513 is reduced from a 6-hour unit
of service to a 5-hour unit of service. The amount of reimbursement
for a 5-hour unit of service is changed to $349.20 to reflect the reduction
in reimbursable time. Rates of reimbursement for the other procedure
codes are specified and are no longer listed as "By Report."
See http://www.maine.gov/bms/rulemaking/
for rules and related rulemaking documents.
EFFECTIVE DATE: May 1, 2004
AGENCY CONTACT PERSON: Julie Tosswill
AGENCY NAME: Bureau of Medical Services, 11 State House Station, Augusta,
ME 04333-0011
TELEPHONE: (207) 287-9360
FAX: (207) 287-9369
TTY: (800) 423-4331 or (207) 287-1828 (Deaf/Hard of Hearing)
AGENCY:
10-144 - Department of Human Services, Bureau of Medical Services
CHAPTER NUMBER AND TITLE: Ch. 104, Drugs for the Elderly and
Disabled Benefit (DEL)
ADOPTED RULE NUMBER: 2004-144
CONCISE SUMMARY: This rule amends Ch. 104, Section 2, Maine Drugs for
the Elderly and Disabled benefit (DEL). These rules set reimbursement
to pharmacy providers at the lowest of 1) the usual and customary charge;
or 2) average wholesale price (AWP) minus 15% (plus a $2.35 professional
fee), or 3) the Maine maximum allowable cost (plus a $2.35 professional
fee). These rules allow the Department to add mail order pharmacy coverage
for the DEL benefit. Mail order pharmacies will supply generic drugs
at AWP minus 60% plus $ 1, and brand name drugs at AWP minus 20% plus
$ 1. These mail order savings will be passed on to DEL participants,
who will receive 90-day supplies of their prescription drugs, and will
pay 20% plus $1 of the reimbursement for each prescription filled under
the Basic benefit.
See http://www.maine.gov/bms/rulemaking/
for rules and related rulemaking documents.
EFFECTIVE DATE: May 2, 2004 AGENCY CONTACT PERSON: Patricia Dushuttle,
Comprehensive Health Planner
AGENCY NAME: Division of Policy & Provider Services
ADDRESS: 11 State House Station, 442 Civic Center Drive, Augusta, Maine
04333-0011
TELEPHONE: (207) 287-9362
FAX (207) 287-9369
TTY: (800) 423-4331 or 207-287-1828 (Deaf/Hard of Hearing)
AGENCY:
10-144 - Department of Human Services, Bureau of Medical Services
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual
(MBM): Ch. II Section 60, Medical Supplies and Durable Medical
Equipment
ADOPTED RULE NUMBER: 2004-145
CONCISE SUMMARY: This final rule does away with the requirement that
rates of reimbursement for oxygen supplies and equipment be linked to
Medicare established rates. This change has resulted in the Department
reducing the rates for codes E0424, E043 9 and E1390 from $230.17 per
month to $195.00 and codes E0431 and E0434 from $36.19 to $31.00.
See http://www.maine.gov/bms/rulemaking/
for rules and related rulemaking documents.
EFFECTIVE DATE: May 2, 2004
AGENCY CONTACT PERSON: Greg Nadeau, Comprehensive Health Planner II
AGENCY NAME: Bureau of Medical Services, Division of Policy and Provider
Services
ADDRESS: 11 State House Station, Augusta, Maine 04333-0011
TELEPHONE: (207) 287-9367, (800) 321-5557 option 9
TTY (207) 287-3094 or (800) 423-4331
AGENCY:
10-144 - Department of Human Services, Bureau of Medical Services
CHAPTER NUMBER AND TITLE: Adopted Rule - Ch. 101, MaineCare Benefits
Manual: Ch. II and III Section 90, Physician Services, including
Ch. II Appendix A
ADOPTED RULE NUMBER: 2004-146
CONCISE SUMMARY: This rule permanently adopts emergency rules currently
in effect to require prior authorization for some surgeries previously
not prior authorized including, but are not limited, to bunion surgery,
circumcision, and skin tag removal.
This rule also adopts major revisions of Section 90 that change and
update coverage of physician services. New service limits have been
adopted and the Department has updated guidelines for preventive services
including physical exams, and tobacco cessation services. The rules
also update guidelines and criteria for certain implants and move transplant
procedure criteria to Appendix A. The rules require physicians to bill
all injectibles with NDC codes rather than J-codes.
Ch. III is repealed and replaced. Ch. III changes remove local billing
codes, and require providers to use standardized CPT and HCPCS codes.
The rules update billing procedures such that providers will be required
to bill using usual and customary charge, although reimbursement will
remain in accordance with MaineCare policy. The Primary Care Physician
Incentive Payment (PC-PIP) is moved from Ch. III to II.
Changes also include the name change of this program to MaineCare, and
the name of this manual to the MaineCare Benefits Manual (MBM.) The
EPSDT program is now called "Prevention, Health Promotion, and Optional
Services for Members Under Age 21." Other changes provide minor edits
and updates.
See www.maine.gov/bms/rulemaking/
for rules and related rulemaking documents.
EFFECTIVE DATE: May 3, 2004
AGENCY CONTACT PERSON: Patricia Dushuttle, Comprehensive Health Planner
AGENCY NAME: Division of Policy & Provider Services
ADDRESS: 11 State House Station, 442 Civic Center Drive, Augusta, Maine
04333-0011
TELEPHONE: (207) 287-9362
FAX: (207) 287-9369
TTY: (800) 423-4331 or (207) 287-1828 (Deaf/Hard of Hearing)
AGENCY:
10-144 - Department of Human Services, Bureau of Medical Services
CHAPTER NUMBER AND TITLE: Final Rule: Ch. 101, MaineCare Benefits
Manual: Ch. VI Section 1, Primary Care Case Management Services
ADOPTED RULE NUMBER: 2004-147
CONCISE SUMMARY: This final rule will discontinue payment of the monthly
primary care case management fee to hospital based/owned physician practices
that are reimbursed through the Medicare cost report. In addition, this
final rule adopts the addition of pediatrician to the definition of
who can be a primary care provider because it was mistakenly left off
the list the last time the rule was amended.
See www.maine.gov/bms/rulemaking/
for rules and related rulemaking documents.
EFFECTIVE DATE: May 2, 2004
AGENCY CONTACT PERSON: Linda Schumacher
AGENCY NAME: Division of Policy and Provider Services
ADDRESS: 11 State House Station, 442 Civic Center Drive, Augusta, Maine
04333-0011
TELEPHONE: (207) 287-9370
FAX: (207) 287-9369
TTY: (800) 423-4331 or (207) 287-1828 (Deaf/Hard of Hearing)
AGENCY:
90-590 - Maine Health Data Organization
CHAPTER NUMBER AND TITLE: Ch. 50, Prices for Data Sets, Fees
for Programming and Report Generation, Duplication Rates
ADOPTED RULE NUMBER: 2004-148
CONCISE SUMMARY: This rule lists new prices for data sets available
to the public from the Maine Health Data Organization, revised fees
for programming and report generation, and duplicating charges. The
proposed rule will entirely replace the existing language found in Ch.
50.
EFFECTIVE DATE: May 2, 2004
CONTACT PERSON: Alan M. Prysunka, Executive Director
AGENCY NAME: Maine Health Data Organization
ADDRESS: 151 Capitol Street, 102 State House Station, Augusta, ME 04333-0102
TELEPHONE: (207) 287-6722
AGENCY:
01-015 - Maine Milk Commission
CHAPTER NUMBER AND TITLE: Ch. 3, Schedule of Minimum Prices -
Order #05-04
ADOPTED RULE NUMBER: 2004-149
CONCISE SUMMARY: Minimum May, 2004 Class I price is $22.90 plus $0.15/cwt.
for Producer Margins and an over order premium of $1.10/cwt. as being
prevailing in southern New England for a total of $24.15. Class II minimums
set at $14.94 for March, 2004 which includes $0.15/cwt. for Producer
Margins. These changes were passed on in minimum prices.
Minimum prices can be found at http://www.maine.gov/agriculture/ahi/mmc/prihis.htm.
EFFECTIVE DATE: May 1, 2004
AGENCY CONTACT PERSON:
NAME: Stanley K. Millay, Executive Director, Maine Milk Commission,
Deering Building - Station #28, Augusta, Maine 04333
TELEPHONE: (207) 287-3741
AGENCY:
02-031 - Department of Professional & Financial Regulation, Bureau
of Insurance
CHAPTER NUMBER AND TITLE: Ch. 940, Requirements for Health Insurance
Rate Filings and Data Reporting
ADOPTED RULE NUMBER: 2004-150
CONCISE SUMMARY: The primary purpose of this amendment is to set forth
filing standards for small group health insurance rates consistent with
2003 Public Law Ch. 469, which (1) amended Maine's small group law,
24-A MRSA §2808-B and (2) requires all rate filings to reflect the impact
of the operation of Dirigo Health.
EFFECTIVE DATE: May 3, 2004
AGENCY CONTACT PERSON: Jennifer Rice
AGENCY NAME: Bureau of Insurance
ADDRESS: 34 State House Station, Augusta ME 04333
TELEPHONE: (207) 624-8460
© Department
of the Secretary of State
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