MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 65, Behavioral Health Services

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes.  The MaineCare Benefits Manual is available on-line at the Secretary of State’s website

Below, please find a Notice of Agency Rule-making Proposal. You can access the complete rule at http://www.maine.gov/dhhs/oms/rules/index.shtml.

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Notice of Agency Rule-making Proposal

AGENCY:  Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND TITLE: 10-144, C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 65, Behavioral Health Services

PROPOSED RULE NUMBER:

CONCISE SUMMARY:

The Department of Health and Human Services (the "Department") proposes the following changes to 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter II, Section 65, Behavioral Health Services.

The Department proposes this rule to incorporate various new Intensive Outpatient Program (IOP) Services to be covered in Chapter II, including Mental Health, Developmental Disabilities/Behavioral Health, Geriatric, Dialectical Behavior Therapy, and Eating Disorder (Level I and Level II) IOPs. The proposed rule updates Substance Use IOP requirements and establishes requirements for new IOP services to include: IOP service and staff requirements, general and specific member eligibility criteria, as well as program requirements.

To align with federal regulations under 42 C.F.R. Part 8, the Department proposes to amend language in Chapters II and Chapter III referring to Medication Assisted Treatment with Methadone (MAT), to be replaced with the term Opioid Treatment Program (OTP) with Methadone. The proposed Chapter II rule also updates requirements for OTPs, under Section 65.05-11, to align with the federal regulation including Counseling, Substance Use Disorder Testing, Medication Administration, and Facility Operation requirements in 42 C.F.R. § 8.12.

To reduce barriers to services and administrative burden to providers, the Department proposes to extend the Crisis Resolution Services “treatment episode” under 65.05-1, from limiting the service to “six (6) face-to-face visits and related follow up phone calls over a thirty (30) day period after the first face-to-face visit,” to “face-to face visits and related follow up phone calls, as clinically indicated, up to a sixty-day period after the first face-to-face visit.” Additionally, the Department proposes to remove language from Section 65.07-5(B) that limits substance use individual and family outpatient therapy to three (3) hours per week, for thirty (30) weeks in a forty (40) week period.

The rule also proposes to clarify qualified staff allowed to provide Crisis Resolution Services (65.05-1) and Crisis Residential Services (65.05-2) to include Clinicians (as defined in 65.01-11), Mental Health Rehabilitation Technicians (MHRTs), Behavioral Health Professionals (BHPs), or Direct Support Professionals (DSPs) with Certification at the level appropriate for the services being delivered and specific to the population being served.

The Department has also updated provider qualifications for licensed Mental Health Agencies and Substance Use Agencies to remove the requirement that providers must separately contract with the Office of Child and Family Services and/or the Office of Behavioral Health.

The proposed rule reorganizes requirements related to Individualized Treatment Plans in 65.08-4(B) and proposes updated requirements for treatment plans for members receiving OTP services.

In addition, the Department is proposing rulemaking to Ch. III of Section 65,  to meet all Chapter II-related rulemaking updates and related budget initiatives identified in P.L. 2021, ch. 398. The Chapter III, Section 65 rulemaking shall be filed simultaneously, so that the upcoming changes will be effective at the same time as the changes in Chapter II, Section 65 are finally adopted.

Throughout the rule, the Department proposes edits to language to make updates to formatting, citations, and references where necessary, including changes to address potentially stigmatizing language based on recommendations from the Maine opioid task force and legislation passed in 2018 to minimize stigma (P.L. 2017, ch. 407).

The Department shall seek CMS approval for the new covered services and provider requirements, as specifically noted in various proposed rule changes.

See http://www.maine.gov/dhhs/oms/rules/index.shtml  for rules and related rulemaking documents.

STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173; 42 C.F.R. Part 8; P.L. 2019, ch. 407; P.L. 2021, Ch. 398

DATE, TIME, AND LOCATION OF PUBLIC HEARING: Tuesday, June 28th, 2022; 1:00 pm

Due to the ongoing threat posed by COVID-19, DHHS has determined that its public hearing will be conducted solely remotely, via Zoom. This is in accordance with the DHHS Remote Rulemaking Hearings Policy issued September 10th, 2021.

(Link to Remote Hearings Policy: https://www.maine.gov/dhhs/sites/maine.gov.dhhs/files/inline-files/9%209%2021%20Remote%20Rulemaking%20Hearings%20Policy.pdf )

Zoom Meeting link: https://mainestate.zoom.us/j/85325347788   Meeting ID: 853 2534 7788

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Meeting ID: 853 2534 7788
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Some devices may require downloading a free app from Zoom prior to joining the public hearing event. The Department requests that any individual requiring special arrangements to participate in the hearing

DATE FILED WITH THE SECRETARY OF STATE’S OFFICE: Tuesday, May 31, 2022.

COMMENT DEADLINE: Comments must be received by 11:59 pm on July 8th, 2022.

AGENCY CONTACT PERSON:       Melanie Miller, Comprehensive Health Planner II

                                                           melanie.miller@maine.gov

AGENCY NAME:                              MaineCare Services

ADDRESS:                                        109 Capitol Street, 11 State House Station, Augusta, Maine 04333-0011

TELEPHONE:                                    207-624-4087 FAX: (207) 287-1864

                                                           TTY: 711 (Deaf or Hard of Hearing)

IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties

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