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 X
Sec2 144-101-X-1 - Benefit for People Living with HIV/AIDS
Subsection 144-101-X-1.05 - COVERED SERVICES
The following MaineCare categories of services and respective policies of the MaineCare Benefits Manual(MBM) are included in the limited benefit for enrollees under this Section::
|
General Category of Service |
Services |
|
Inpatient |
MBM Chapter II, Section 45, Hospital Services |
|
Psychiatric Facility |
MBM Chapter II, Section 46, Psychiatric Hospital Services |
|
Outpatient |
MBM Chapter II, Section 45, Hospital Services |
|
EPSDT Examinations |
MBM Chapter II, Section 94, Early and Periodic Screening, Diagnosis and Treatment Services (EPSDT); Section 90, Physician Services Examinations: Physician Services) |
|
Medications |
MBM Chapter II, Section 80, Pharmacy Services |
|
Community Support Services |
MBM Chapter II, Section 17, Community Support Services; The Department shall seek and anticipates receiving approval for this section from the Centers for Medicare and Medicaid Services (CMS). Pending approval, covered services will include Section 92, Behavioral Health Home Services |
|
Lab & X-ray |
MBM Chapter II, Section 55, Laboratory Services; Section 101, Medical Imaging Services |
|
Transportation |
MBM Chapter II, Section 113, Non-Emergency Transportation Services; benefit will only pay for transportation to and from MaineCare covered services; Section 5, Ambulance Services |
|
Ambulatory Care |
MBM Chapter II, Section 3, Ambulatory Care Clinic Services; The Department shall seek and anticipates receiving approval for this section from the Centers for Medicare and Medicaid Services (CMS). Pending approval, covered services will include Section 4, Ambulatory Surgical Center Services |
|
Case Management |
MBM Chapter II, Section 13.03, Targeted Case Management Services |
|
Family Planning |
MBM Chapter II, Section 30, Family Planning Agency Services |
|
Behavioral Health |
MBM Chapter II, Section 65, Behavioral Health Services (including Psychological Services); Section 92, Behavioral Health Home Services |
|
Medicare Crossover-A |
MBM Chapter II, Section 45, Hospital Services |
|
STI/STD Testing and Treatment |
MBM Chapter II, Section 30, Family Planning Services; Section 90, Physician Services |
|
Medicare Crossover-B |
MBM Chapter II, Section 90, Physician Services; Section 31, Federally Qualified Health Center Services; Section 103, Rural Health Clinic Services |
|
Physician, Physician Assistant, Advanced Practice Registered Nurse, Certified Nurse Practitioner, Ophthalmologist |
MBM Chapter II, Section 90, Physician Services; Section 14, Advanced Practice Registered Nursing Services; The Department shall seek and anticipates receiving approval for this section from the Centers for Medicare and Medicaid Services (CMS). Pending approval, covered services will include Section 91, Health Home Services; Section 31, Federally Qualified Health Center Services; Section 103, Rural Health Clinic Services, and Section 9, I ndian Health Services |
|
Services for Children with Intellectual Disability or Autism |
MBM Chapter II, Section 28, Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations |
|
Developmental and Behavioral Clinical Services |
MBM Chapter II, Section 23, Developmental and Behavioral Clinic Services |
|
Substance Abuse Treatment |
MBM Chapter II, Section 65, Behavioral Health Services |
