Notice of Agency Waiver Amendment, MaineCare Benefits Manual, Section 18, Home and Community Based Services (HCBS) for Members with Brain Injury

Date posted:

Attachment(s):

Notice of Agency Waiver Amendment

AGENCY:  Department of Health and Human Services, MaineCare Services

RULE TITLE OR SUBJECT: Chapter 101, MaineCare Benefits Manual, Section 18, Home and Community Based Services (HCBS) for Members with Brain Injury

WAIVER: ME.1082, Home and Community Based Services for Members with Brain Injury Waiver

CONCISE SUMMARY: The proposed changes include the following: 

General

  • Updates and includes new information related to the 2024 revised 1915(c) HCBS Waiver Application, version 3.7 where applicable.

Waiver Appendix C 

  • The Department is updating requirements for Direct Care Worker staff to reflect changes in the certification curriculum and ongoing training requirements.

Waiver Appendix F-3

  • The Department is updating its grievance procedures for members served under any of the 1915(c) waivers to comply with new Federal requirements Ensuring Access to Medicaid Services (CMS-2442-F)  (Access Final Rule, CMS 2442-F).  The Office of Aging and Disability Services (OADS) is promulgating rules related to the new grievance process.

Waiver Appendix I

  • Clarifies that service rates for this waiver are contingent on available funding and subject to legislative approval.
  • This waiver amendment adjusts the funding and rate for Home Support Level III services to reflect the elimination of health care services from the Maine State Service Provider Tax in accordance with 36 M.R.S. § 2552. This adjustment removes the cost of the former tax from the calculation of the rate amount. The impacted service codes are:

Procedure Code

Modifier

Description

T2016

U9 TG

Home Support Level III Increased Neurobehavioral

T2016

U9 TG TT

Home Support Level III Increased Neurobehavioral

 

Waiver Appendix J 

  • Updates Cost Neutrality and Derivation of Estimates for Waiver Years 2 through 5. 

Finally, as part of this waiver submission, the Department has made technical revisions, formatting updates, and other non-substantive changes to the application. Please see the accompanying draft application for a complete list of all proposed changes included in the waiver amendment. 

DHHS is accepting comments through 11:59 pm, March 29, 2026. Any interested party may obtain a copy of the waiver amendment by going to the website noted below or at any regional Office for Family Independence (a list of the offices and locations can be found at this link http://www.maine.gov/dhhs/ofi/offices/index.html).

A printed copy may be obtained by calling Lisa Weaver at (207) 624-4050 or emailing lisa.weaver@maine.gov.

See http://www.maine.gov/dhhs/oms/rules/index.shtml for waiver amendment and to submit comments.

STATUTORY AUTHORITY:              42 CFR §441.304

DEADLINE FOR COMMENTS:        Comments must be received by 11:59 pm, March 29, 2026.

AGENCY CONTACT PERSON:        Heather Bingelis, Comprehensive Health Planner II

AGENCY NAME:                              MaineCare Services

ADDRESS:                                         109 Capitol Street, 11 State House Station

                                                            Augusta, Maine 04333-0011

                                                            Heather.bingelis@maine.gov

TELEPHONE:                                    207-624-4951 FAX: (207) 287-1864 TTY: 711

Office: MaineCare Services

Comment deadline:

Comments for this rule have been closed.