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-19.10 - REIMBURSEMENT

A. The amount listed in Chapter III, Section 19, "Allowances for Home and Community Benefits for the Elderly and Adults with Disabilities" for members authorized for these services;

B. The servicing provider's usual and customary charge; or

C. The fee negotiated between the Waiver Services Provider and providers contracted for Environmental Modifications.

In accordance with Chapter I, it is the responsibility of the provider to seek payment from any other resources (private or group insurance benefits, Workers' Compensation, Medicare, etc.) that are available for payment of a rendered service prior to billing MaineCare. Therefore, a service provider under these HCB is expected to seek payment from sources other than MaineCare that may be available to the member. Providers should document all efforts to collect from a third party.