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-91 - Physician Services
Subsection 144-101-II-91.05 - POLICIES AND PROCEDURES
Current through 2024-38, September 18, 2024
91.05-1 Member Identification
Members may request CCT or HOME services or be referred for CCT or HOME services from any point-of-care at which the Member's needs for CCT or HOME services are identified.
CCTs and HOME Providers shall accept referrals and assess Members who are potentially eligible for covered services based on the eligibility criteria in 91.03 and 91.04. CCTs and HOME Providers shall enroll qualifying Members for CCT or HOME services.
91.05-2 Enrollment and Duplication of Services
Provider at any given time. If, through the enrollment process, the Member is determined to be receiving a duplicative service, the Member shall choose which service they want to receive. CCTs and HOME Providers shall provide Members with notice that the Members cannot receive duplicative services. The Member's choice of services will be retained in the Member's EHR. CCT or HOME Provider services do not preclude a Member from receiving other medically necessary services.
Members may not receive CCT or HOME services that duplicate services from other sections of the MaineCare Benefits Manual, including the following services:
MaineCare services that are covered concurrently with HOME services only for a thirty (30) day overlap from the date of admission or sixty (60) day overlap prior to the date of discharge to allow for comprehensive transitional care include:
