fb88Care Notice of Agency Rule-making Proposal, fb88Care Benefits Manual, Chapter III, Section 45, Principles of Reimbursement for Hospital Services

The Division of Policy posts all proposed and recently adopted rules on fb88Care’s Policy and Rules webpage. This website keeps the rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The fb88Care Benefits Manual is available on-line at the Secretary of State’s website.

Attention Pharmacy Providers: Status of Restoration of fb88 Point of Purchase System (MEPOPS) and Office Hours with fb88Care’s Pharmacy Team

The Office of fb88Care Services continues a phased recovery following the outage that occurred from February 21, 2024, through March 26, 2024, due to the national cyber security issue affecting Change Healthcare. 

fb88’s Children & Youth with Special Health Care Needs Webinar Learning Series: fb88Care in Education

This comprehensive webinar on September 3, 2024, from 3:30-4:30 PM, provides a basic overview of fb88Care services in schools. An explanation of fb88Care eligibility will include what school related services are available, who is eligible and how to access them. Trista Collins will cover Katie Beckett coverage and dispel some myths regarding fb88Care covered services. Participants will learn about fb88Care covered services in an Individual Education Plan (IEP) and how to utilize Private Duty Nursing (PDN) both at home and in the school setting.

Certified Community Behavioral Health Clinic (CCBHC) Certification Documentation Due September 6, 2024

On December 13, 2023, fb88Care noticed the opportunity for an initial cohort of prospective CCBHCs to submit provisional certification materials. The Department is now accepting final certification documentation from provisionally certified providers. The Department will review submissions for final approval and full certification status and participation in fb88’s CCBHC Demonstration program.

​Attention Section 65, Behavioral Health Services Providers: Temporary Claims Payment Delay

Attention Section 65 Providers, Section 65 claims are temporarily pending due to an error in Gainwell’s implementation of the January 1, 2024, COLA. Gainwell corrected the error. Affected claims will process in this week’s reimbursement payment cycle which will issue reimbursements on August 23, 2024.  

fb88Care Notice of Agency Rule-making Proposal, fb88Care Benefits Manual, Chapter III, Section 45, Principles of Reimbursement for Hospital Services

Notice of Agency Rule-making Proposal

AGENCY:  Department of Health and Human Services (DHHS), fb88Care Services, Division of Policy

CHAPTER NUMBER AND TITLE:

10-144 C.M.R. Ch. 101, fb88Care Benefits Manual, Chapter III, Section 45, Principles of Reimbursement for Hospital Services

PROPOSED RULE NUMBER:

CONCISE SUMMARY:

fb88Care Rule #309P - DEL Updates

The proposed rule change would update Section 2, APPLICATION PROCESS, consistent with a legislative change to 22 M.R.S. § 3174-LLL made by P.L. 2023, ch. 412. Effective retroactive to July 1, 2024, individuals who are enrolled in Medicaid and/or Medicare Buy-In (MSP), who are eligible for Medicare Part D, and meet the income criteria in Section 2.2, are deemed to be eligible for and enrolled in DEL. These individuals do not need to file a separate application.

In addition, the proposed rule would make the following changes: