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-31 - Federally Qualified Health Center Services
Subsection 144-101-II-31.01 - DEFINITIONS

31.01-1 Ambulatory services are services provided by a federally qualified health center other than those core services described in Section 31.04-1 that are also included in the State's Medicaid Plan and that are provided in accordance with all applicable sections of the MaineCare Benefits Manual. This includes dental services provided by dentists, independent practice dental hygienists (effective October 1, 2013, subject to approval by CMS),dental hygienists, and licensed dental entities.

31.01-2 Covered services are those services described in Section 31.04 for which payment can be made under Title XIX and XXI by the Department of Health and Human Services.

31.01-3 Federally Qualified Health Center (FQHC) refers to a facility or program that is federally qualified and may also be known as a community health center, migrant health center, or health-care program for the homeless. A center is "federally qualified" if it:

31.01-4 Federally Qualified Health Center Services are those primary health-care (core services) and other ambulatory services furnished by the facility's professional and other qualified staff during a visit.

31.01-5 Homebound member is defined as an individual who is confined permanently or temporarily to his or her place of residence because of a medical or health condition. The individual may be considered homebound if he or she leaves the place of residence infrequently. For this purpose, "place of residence" does not include a hospital or long-term care facility.

31.01-6 Plan of treatment is a written plan of medical services for part-time or intermittent visiting nurse care that is established and reviewed at least every sixty (60) days by a supervising physician of the health center. When delegated by the supervising physician, and when in compliance with all other State licensure requirements, it may also be established by a physician assistant, nurse practitioner, nurse midwife, or specialized nurse practitioner and reviewed and approved at least every sixty (60) days by a supervising physician of the health center.

31.01-7 Primary health care refers to preventative, diagnostic and therapeutic services furnished by the health center's professional staff and, where appropriate, the supplies commonly used to support those services, basic laboratory services essential for diagnosis and treatment, and emergency medical care for the treatment of life-threatening injuries and acute illness.

31.01-8 FQHC unit of service is a visit that includes a face-to-face contact with one or more of the center's core or ambulatory professional and other qualified staff and, where appropriate, receipt of supplies, treatments, and laboratory services.

31.01-9 Incidental Services and Supplies refer to certain services and supplies authorized by licensed medical, dental and mental health practitioners.