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-43 - Hospice Services
Subsection 144-101-II-43.01 - DEFINITIONS

43.01-1 Attending Physician must be a medical doctor of medicine or osteopathy, nurse practitioner, or physician assistant licensed to practice in the State of Maine (or the state in which the services are provided). The Attending Physician provides services within the scope of practice of his or her profession as defined by Maine (or applicable law), identified by the member at the time he or she elects to receive hospice care as having the most significant role in the determination and delivery of the member's medical care.

43.01-2 Benefit Period is the time period of consecutive days during which medical benefits for covered services, within certain maximum limits, are available to the Member.

43.01-3 Department means the Maine Department of Health and Human Services.

43.01-4 Hospice is any public, private or non-profit organization, or a subdivision of such an organization, that is primarily engaged in providing pain relief, symptom management, and support services to terminally ill members and their families. For a hospice to receive MaineCare reimbursement, it must be Medicare-certified and licensed under applicable state or provincial law.

43.01-5 Hospice Services are a range of interdisciplinary services provided twenty four (24) hours a day, seven days a week to a person who is terminally ill and to that person's family. These services are to be delivered in the least restrictive setting possible by volunteers and professionals who are trained to help the member with physical, social, psychological, spiritual and emotional needs related to the terminal illness with the least amount of technology possible. Services are focused on pain relief and symptom management and are not curative in nature.

43.01-6 Interdisciplinary Team is the team that manages the hospice services provided to the terminally ill member and the member's family. The team includes at least the following individuals: a doctor of medicine or osteopathy, a physician assistant, a registered nurse, a medical social worker and a counselor as outlined in Section 43.06-3. All individuals must be employees of the hospice, except the physician who may be a contractor of the hospice.

43.01-7 Medical Director must be a hospice employee or contractor who is a doctor of medicine or osteopathy licensed in the state in which services are provided, who has overall responsibility for the medical component of patient care at the hospice.

43.01-8 Representative is an individual authorized under state or provincial law to end medical care or to elect or revoke the election of hospice care on behalf of a terminally ill member who is mentally or physically incapacitated. For purposes of making health care decisions, a member's representative may also be a "guardian," "agent" or "surrogate," as these terms are defined in 18-C MRS §5-802.

43.01-9 Terminal Illness is a medical condition resulting in a prognosis that a member has a life expectancy of six (6) months or less if the illness runs its normal course.