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May 5, 2004
as posted in 5 daily Maine newspapers

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


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