№ files_lp_3_process_7_041761
File format: docx
Character count: 99091
File size: 149 KB
Year:
2023
Region / City:
Maine
Theme:
Health care services
Document type:
Policy
Agency:
MaineCare
Author:
Maine Department of Health and Human Services
Target audience:
MaineCare providers and beneficiaries
Period of validity:
Ongoing
Approval date:
N/A
Amendment date:
N/A
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Year:
2025
Region / City:
Maine
Theme:
Healthcare, Medicaid
Document Type:
Manual
Institution:
Department of Health and Human Services, Office for Family Independence
Author:
State of Maine
Target Audience:
General public, healthcare professionals, individuals seeking MaineCare benefits
Period of Validity:
Until April 29, 2025
Approval Date:
April 29, 2025
Date of Changes:
Not specified
Year:
2025
Region / City:
Maine
Topic:
Healthcare Eligibility
Document Type:
Manual
Organization:
Department of Health and Human Services, Office for Family Independence
Author:
Unknown
Target Audience:
State officials, healthcare providers, and applicants for MaineCare
Period of Validity:
Effective April 29, 2025
Approval Date:
Not specified
Date of Last Update:
April 29, 2025
Contextual Description:
A policy manual providing eligibility criteria and administrative processes for MaineCare, including coverage groups, benefits, and eligibility verification methods.
Year:
2023
Region / City:
Maine
Subject:
Home Health Care Services
Document Type:
Regulations
Agency:
MaineCare
Author:
Maine Department of Health and Human Services
Target Audience:
Healthcare providers, home health agencies, certified home health aides, and healthcare professionals involved in home care services
Effective Period:
Ongoing
Approval Date:
N/A
Date of Amendments:
N/A
Year:
N/A
Region / City:
Maine
Topic:
Medicaid Administration
Document Type:
Policy Manual
Organization / Institution:
Maine Department of Health and Human Services
Author:
N/A
Target Audience:
Health Providers, MaineCare Participants
Validity Period:
N/A
Approval Date:
N/A
Modification Date:
N/A
Note:
Year
Subject:
Speech and Hearing Services
Document Type:
Policy
Organization:
MaineCare
Target Audience:
Healthcare Providers, Speech and Hearing Professionals
Context Description:
Policy detailing specific billing codes and modifiers for speech and hearing services covered under MaineCare, including professional rates for various diagnostic and treatment procedures.
Jurisdiction:
State of Maine, United States
Program:
MaineCare
Governing Law:
Title XVIII, XIX, and XXI of the Social Security Act; 42 U.S.C.A. §§1395 et seq.; 42 U.S.C.A. §§1396 et seq.; 42 U.S.C. §1397; 22 M.R.S. §§10, 12, 42(1), 3173 et seq.; 22 M.R.S. §1901 et seq.; 22 M.R.S. §3174-T
Administering Authority:
Maine Department of Health and Human Services
Federal Oversight:
Centers for Medicare and Medicaid Services (CMS)
Document Type:
Benefits manual / administrative regulations
Subject:
Administration, provider participation, member eligibility, covered services, reimbursement, compliance, appeals, and program integrity
Related Programs:
Medicare; Medicaid; State Children’s Health Insurance Program (CHIP); Cub Care Program
Responsible Units:
Office for Family Independence; Program Integrity Unit; Division of Audit; Office of MaineCare Services
Scope:
Statewide administration of MaineCare benefits and services
Year:
2022
Region / City:
Maine
Theme:
Healthcare Services for Children and Adolescents
Document Type:
Guidelines
Organization:
MaineCare
Author:
Maine Department of Health and Human Services
Target Audience:
Healthcare Providers, MaineCare Members, and Their Caregivers
Effective Period:
Ongoing
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2015
Region / City:
Maine
Topic:
Non-Emergency Transportation
Document Type:
Policy and Procedure
Organization / Institution:
Maine Department of Health and Human Services
Author:
MaineCare Services
Target Audience:
MaineCare Members, Transportation Providers, Brokers
Effective Period:
From 4/5/2015
Approval Date:
4/5/2015
Date of Last Update:
4/5/2015
Effective Date:
11/18/14
Program:
MaineCare
Jurisdiction:
Maine
Country:
United States
Issuing Authority:
Department of Health and Human Services
Regulatory References:
45 C.F.R. §162.1000; 45 C.F.R. §1011; 42 C.F.R. §447.205
Related Agency:
Centers for Medicare and Medicaid Services (CMS)
Document Type:
Reimbursement rate schedule and billing code list
Subject:
Family planning services and related medical procedures
Code System:
Healthcare Common Procedure Coding System (HCPCS)
Update Frequency:
Approximately quarterly updates issued by CMS
Provider Requirements:
Use of FP modifier for applicable services; CLIA-waiver certificate required for certain laboratory codes
Reimbursement Basis:
Fee-for-service rates
State Plan Requirement:
Payment subject to approval of a state plan amendment by CMS
Publication Method:
Notices of reimbursement methodology change and revised billing instructions
Web Reference:
www.maine.gov/dhhs/audit/rate-setting/index.shtml
Year:
2012
Region / City:
Maine
Topic:
Occupational Therapy Services
Document Type:
Policy document
Organization:
MaineCare
Author:
MaineCare
Target Audience:
Healthcare providers and occupational therapists
Period of Validity:
Ongoing
Approval Date:
06/29/12
Modification Date:
None
Year:
2026
Region:
Maine, USA
Topic:
Healthcare Payment and Delivery Model
Document Type:
Policy and Program Manual
Organization:
Maine Department of Health and Human Services
Author:
MaineCare Program Administration
Target Audience:
Primary Care Providers and MaineCare Members
Participation:
Voluntary for both providers and members
Payment Model:
Population-Based Payments with Performance-Based Adjustments
Implementation Period:
Ongoing
Certification Reference:
CEHRT under 42 CFR §414.1305
Legal Authority:
Social Security Act Section 1905(t)(1)
Scope:
Primary care, behavioral health integration, care plans, and community health workers
Operational Structure:
Accountable Communities, Joint Care Management, Community Care Teams
Risk Assessment:
Member attribution, risk scores, and performance measures
Reimbursement Mechanism:
Tiered PBPs and quarterly PBAs
Year:
2025-26
Region / City:
United States
Subject:
Financial Aid, Intellectual Disabilities
Document Type:
Instructions
Institution:
U.S. Department of Education
Author:
U.S. Department of Education
Target Audience:
Educational institutions participating in Title IV programs
Period of Validity:
2025-26
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2025
Region / City:
West Virginia
Subject:
Fire Protection Services
Document Type:
Legislation
Organization / Institution:
West Virginia Legislature
Author:
Delegate Burkhammer
Target Audience:
Government authorities, municipalities, and businesses affected by fire protection fees
Effective Date:
July 9, 2025
Date of Approval:
April 10, 2025
Date of Amendments:
Not specified
Year:
2025
Region / City:
West Virginia
Topic:
Speed Restrictions
Document Type:
Legislation
Organization / Institution:
West Virginia Legislature
Author:
Delegates Gearheart, Canterbury, Hornby, Ellington, Brooks, Funkhouser, Drennan, Butler, Ridenour, and Dillon
Target Audience:
General public, motorists
Effective Period:
From July 11, 2025
Approval Date:
April 12, 2025
Amendment Date:
Not provided
Year:
2025
Region / city:
West Virginia
Theme:
Employment law, veterans, military spouses
Document type:
Legislation
Organization / institution:
West Virginia Legislature
Author:
Delegates W. Clark, Ridenour, Horst, Hornby, Funkhouser
Target audience:
Employers, veterans, military families, legal professionals
Effective date:
July 9, 2025
Date of approval:
April 10, 2025
Date of amendments:
N/A
Year:
2025
Region / City:
West Virginia
Subject:
Legislation, Environmental Law, Land Use
Document Type:
Bill
Agency / Institution:
West Virginia Legislature
Author:
Senators Jeffries, Clements, Helton, Rose, and Tarr
Target Audience:
Legislators, Environmental Policy Experts, Legal Professionals
Effective Date:
July 8, 2025
Approval Date:
April 9, 2025
Year:
2025
Region / city:
West Virginia
Topic:
Employment Law
Document Type:
Legislative Bill
Author:
Delegates Hanshaw and Hornbuckle
Target Audience:
State Employees and Government Officials
Effective Date:
July 1, 2025
Date of Approval:
April 8, 2025
Date of Amendments:
None
Year:
2025
Region / city:
West Virginia
Topic:
Anesthesia Administration
Document Type:
Legislation
Organization / Institution:
West Virginia Legislature
Author:
Senators Rucker, Fuller, Taylor, Bartlett, Rose, Roberts, Maynard, Hart, and Helton
Target Audience:
Healthcare professionals, legislators
Effective Date:
July 7, 2025
Approval Date:
April 8, 2025
Note:
Date of Amendments
Description:
Legal text outlining the qualifications and procedures for certified registered nurse anesthetists to administer anesthesia in cooperation with physicians, dentists, or podiatrists in West Virginia.
Year:
2025
Region / City:
West Virginia
Topic:
Transportation, Legislative Rules
Document Type:
Legislative Bill
Organization / Institution:
West Virginia Legislature
Author:
Senator Woodrum
Target Audience:
Legislators, Government Officials
Period of Validity:
From passage
Approval Date:
March 12, 2025
Amendment Date:
October 11, 2024
Context Description:
Legislative bill authorizing various divisions within the West Virginia Department of Transportation to promulgate rules related to highways, motor vehicles, and electronic toll collection.
Year:
2025
Region / City:
Northern Kentucky, Florence
Topic:
Mental Health & Substance Abuse Counseling
Document Type:
Request for Proposal
Organization / Institution:
Northern Kentucky Independent District Health Department
Author:
Not specified
Target Audience:
Potential vendors and service providers
Period of Action:
March 31, 2025 onwards
Approval Date:
Not specified
Modification Date:
Not specified