Notice of MaineCare Reimbursement Methodology Change
AGENCY: Department of Health and Human Services, Office of MaineCare Services
SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Section 65, Behavioral Health Services
NATURE OF PROPOSED CHANGES: The Department plans to update reimbursement for tobacco cessation counseling services for non-pregnant individuals included under Section 65 – Behavioral Health Services to align with the reimbursement methodology established in Section 90 – Physicians Services. This means, effective January 14, 2023, that the reimbursement for tobacco cessation under Section 65 will be equal to 72.4% of the Medicare Maine area 99 rate. This reimbursement will update annually consistent with Medicare updates.
REASON FOR PROPOSED CHANGES: The Department is amending reimbursement to align with recently adopted changes to Section 90 - Physician Services in order to create consistent reimbursement for like services.
ESTIMATE OF ANY EXPECTED INCREASE OR DECREASE IN ANNUAL AGGREGATE EXPENDITURES: The Department anticipates that this change will result in an increase of $180 in federal fiscal year 2023 which includes $114 in federal funds and $66 in state funds, and will cost $254 in federal fiscal year 2024 which includes $159 in federal funds and $95 in state funds.
ACCESS TO PROPOSED CHANGES AND COMMENTS TO PROPOSED CHANGES: The public may review the proposed methodology changes and written comments at any Maine DHHS office in every Maine county. To find out where the Maine DHHS offices are located, call 1-800-452-1926.
FOR RECEIPT OF COMMENTS: Kristin Merrill
AGENCY NAME: Office of MaineCare Services
ADDRESS: 109 Capitol Street, 11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: (207) 624-4006 FAX: (207) 287-6106
TTY: 711 Maine Relay (Deaf or Hard of Hearing)
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
State Plan Amendment
Office: MaineCare Services