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-3 - AMBULATORY CARE CLINIC SERVICES
Subsection 144-101-II-3.04 - COVERED SERVICES

3.04-1 Covered Services for School Health Clinics

Covered services include preventive, diagnostic and/or therapeutic services for acute, episodic and chronic conditions furnished by the clinic's professional staff; supplies commonly furnished for the provision of these services; and basic laboratory services essential for immediate diagnosis and treatment.

3.04-2 Interpreter Services

All Ambulatory Care Clinics, when providing covered services as described in this Section of the MaineCare Benefits Manual, shall be reimbursed for interpreter services provided to Medicaid recipients when these services are necessary to communicate effectively with the recipient regarding health care needs.

Providers of interpreter services must be certified by the Registry of Interpreters for the Deaf, Inc., or working under the supervision of an interpreter certified by the Registry of Interpreters for the Deaf, Inc.

Reimbursement will be available for an interpreter's hourly minimum charge and beyond this first hour, reimbursement is based on the quarter hour including associated travel to and from the location where the services are performed.

Additional reimbursement for deaf Medicaid recipients who have non-standard signing, is available consisting of a relay interpreting team including a deaf interpreter, for whom signing his/her native language, working with a hearing interpreter. In such cases, reimbursement for two interpreters will be made.

Reimbursement will be at the interpreter's usual and customary charge not to exceed the amounts listed in Chapter III of this Section.

When requesting reimbursement for Interpreter Services, a statement of verification regarding the interpreter's certification and cost of performing the services shall be documented in the recipient's record.

3.04-3 Flu Clinics

Administration of flu vaccines (seasonal and H1N1) are reimbursable when providers are appropriately enrolled under this Section and approved by the Maine CDC to administer vaccines. Providers must use state-supplied vaccines(provided at no cost to providers) whenever available. State supplied vaccines are available for H1N1 administration to all MaineCare members. The state also supplies seasonal flu vaccines for children. Providers may bill acquisition cost only for seasonal flu administration for adults, in addition to the administration fee. Providers must maintain documentation of acquisition costs to be provided to MaineCare upon request. Providers may bill separately for each vaccine administered. Roster billing is allowed for flu clinics.