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-67 - Principles of Reimbursement for Nursing Facilities
Subsection 144-101-III-67-41 - REMOTE ISLAND NURSING FACILITIES
Current through 2024-38, September 18, 2024
41.1 *In order to qualify as a remote island nursing facility, a nursing facility must meet all of the following criteria:
*The Department shall submit to CMS and anticipates approval for a State Plan Amendment related to this provision.
41.2 Principle. A nursing facility that qualifies as a remote island nursing facility under this section will be reimbursed for services provided to residents covered under the Title XIX program based upon the actual allowable cost of services provided.
41.3 Rate setting. Annually, at the beginning of each facility's fiscal year, the Department will establish the rate based on the latest audited cost report. The allowable per diem cost for the services will be inflated to the beginning of the facility's fiscal year based on Principle 31.
If the facility experiences cost increases in excess of the current interim rate, the provider can request to have the interim rate adjusted. The written request along with the supporting documentation for the rate adjustment should be submitted to:
Department of Health and Human Services
Director, Rate Setting Unit
11 State House Station
Augusta, ME 04333
The Director will review the request and determine if a rate adjustment is necessary.
41.4 Audit. The per diem rate is subject to year-end audit and will be adjusted to the actual allowable costs of providing services to eligible residents during the year.
Except for Principles 22-27, all other sections of these principles pertaining to the allowability, recording, and reporting of costs shall apply.
