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-50 - ICF-MR Services
Subsection 144-101-II-50.08 - NON-COVERED SERVICES

A. Maintenance therapy (repetitive services not requiring the skills of a qualified physical or occupational therapist or the use of complex and sophisticated physical or occupational therapy procedures) is not a covered service, except as provided in Section 50.07-3(D). Services related to activities for the general good and welfare of members, e.g., general exercises to promote overall fitness and flexibility and activities to provide diversional or general motivation, do not constitute physical or occupational therapy for MaineCare purposes.

B. Payment by a relative of an additional amount to enable a member to obtain non-covered services such as a private room (single bed), telephone, television, and authorized bed hold days is permitted. However, the additional charge for non-covered services must not exceed the charge to individuals who privately pay. The supplement for a private room must be no more than the difference between the private pay rate for a semi-private room and a private room.

C. ICF-MR services may not include services of a vocational or academic nature unless the service meets the criteria in Section 50.07-8. These and other services that are non-covered are referred to in Chapter I of the MaineCare Benefits Manual.