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-43.09 - ALLOWANCES FOR HOSPICE SERVICES

Specific reimbursement rates are listed on the MaineCare Provider Fee Schedule, which is posted on the Department's web site in accordance with 22 M.R.S. Sec.3173-J(7).

Rates for Routine Home Care services, both days 1-60 and days over 60, are reimbursed at 123% of the CMS published Medicaid rates, effective October 1 annually, plus an adjustment for regional differences in wages using the hospice wage index.

Continuous Home Care, Inpatient Respite Care, General Inpatient Care and the Service Intensity Add-On services are reimbursed at 100% of the CMS published Medicaid rates, effective October 1 annually, plus an adjustment for regional differences in wages using the hospice wage index.

Hospice providers will be reimbursed a per diem amount to cover room and board services provided by the nursing facility (NF) or intermediate care facility for individuals with intellectual disabilities (ICF-IID) for MaineCare members who have elected hospice care and reside in the NF or ICF-IID. This reimbursement rate is equal to 95 percent (95%) of the base rate paid to that particular facility of residence.

Failure by a hospice provider to comply with the Medicare quality reporting requirements during each fiscal year will result in a two percent (2%) reduction to the market basket update applied prospectively to the following hospice rate year.