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-19 - Home and Community Benefits for the Elderly and Adults with Disabilities
Subsection 144-101-II-19.05 - NON-COVERED SERVICES

A. Services that are not in the Authorized Plan of Care according to Section 19.04, except as allowed under an acute/emergency episode (see Section 19.04-4(A)(13) );

B. Services that are described as non-covered services in Chapter I of theMaineCare Benefits Manual including but not limited to recreational, custodial and leisure activities;

C. Household tasks, except included as IADL services in the Authorized Plan of Care, according to Section 19.04;

D. Respite services and or IADL tasks when delivered by the member's spouse;

E. Attendant Services provided by a spouse of the member, or by the parents or stepparents of a minor child who is a member;

F. Personal Care Services provided by the parents or stepparents of a minor child who is a member;

G. Services provided by anyone prohibited from employment due to criminal background checks or annotations on the Maine Registry of Certified Nursing Assistants and Direct Care Workers as set forth in this Section;

H. Custodial care or supervision;

I. Personal care services delivered in a licensed or unlicensed assisted housing setting, including a residential care facility;

J. Room and board and food (except when allowed as part of Home Delivered Meals or as part of Respite Services delivered in the NF setting);

K. Services provided not in the presence of the member unless in the provision of covered IADLs, such as grocery shopping or laundry while the member remains at home;

L. Services provided when the member is in the hospital, nursing facility, PNMI, or ICF-IID;

M. Supervisory visits for HHAs, CNAs, and PSSs;

N. Services in excess of forty (40) hours per week provided by an individual worker to any individual member or household except as indicated in 19.06-M.

O. Services provided out of state except as otherwise specifically allowed under this Section or as authorized under Chapter I of the MaineCare Benefits Manual; and

P. Personal care or Attendant Services provided to a member receiving respite in an institutional setting because personal care is the responsibility of that provider.