Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter II - Specific Policies By Service
Section 144-101-II-109 - Speech and Hearing Services
Subsection 144-101-II-109.05 - DURATION OF CARE
Current through 2024-38, September 18, 2024
A. Each Title XIX and XXI member is eligible for as many covered services as are medically necessary as determined by the Department of Health & Human Services. The Department reserves the right to request additional information to determine medical necessity; and
B. Members aged twenty-one (21) and older, who receive speech therapy services, must obtain a re-evaluation of their progress in speech therapy by a speech-language pathologist every six (6) months. The report of the speech-language pathologist's progress and prognosis for improved speech, oral/visual communication, swallowing or chewing functioning must be sent to a physician or PCP, who must in turn, determine if the member meets the criteria described in Section 109.04, "Specific Eligibility for Care". Services will be covered only as long as the member meets the eligibility requirements in 109.04.
