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 III - Allowances for Services
Section 144-101-III-107 - Principles of Reimbursement for Psychiatric Residential Treatment Facility Services
Subsection 144-101-III-107-2 - REQUIREMENTS FOR PARTICIPATION IN MAINECARE PROGRAM
Universal Citation: 10 ME Code Rules ยง 144-101-III-107-2
Current through 2024-38, September 18, 2024
2.1 Psychiatric Residential Treatment Facilities (PRTFs) must satisfy all of the following prerequisites in order to be reimbursed for care provided to MaineCare members:
2.1.1 be licensed and certified by the Maine
Department of Health and Human Services-Center for Disease Control and
Prevention, pursuant to
22 M.R.S.
§8101(4-B) and
42 CFR,
Part 441, Subpart D, and 107.2-1.2 have a MaineCare Provider Agreement with the
Department of Health and Human Services.
2.1.2
MaineCare payments shall
not be made to any facility that fails to meet all the requirements of
Principle 2.1.
2.1.3
Medical,
Clinical, and Direct Care Services means services provided by a
qualified provider directly to a member in a PRTF as outlined in Chapter II,
Section 107 in accordance with covered services described in Chapter II Section
107.
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