Resolve, To Eliminate Financial Inequality in MaineCare Reimbursement for Community-based Behavioral Health Services

Sec. 1. Rulemaking regarding MaineCare reimbursement for community-based behavioral health services. Resolved: That, by October 1, 2014, the Department of Health and Human Services shall amend the rules of reimbursement for behavioral health services under the MaineCare program to provide that all community-based behavioral health services covered pursuant to Chapter 101, MaineCare Benefits Manual, Chapter II, Section 65 are reimbursed at the same rates set forth in Chapter 101, MaineCare Benefits Manual, Chapter III, Section 65 as applicable to community-based agencies. The amended rules must prohibit a community-based agency that operates as part of a hospital or is an administrative unit of a hospital from billing for Section 65 behavioral health services at hospital rates. The rules adopted pursuant to this section are routine technical rules under the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A.

SUMMARY

This resolve directs the Department of Health and Human Services to amend the rules of reimbursement for behavioral health services under the MaineCare program to provide that all community-based behavioral health services are reimbursed at community-based rates. The amended rules must prohibit billing at hospital rates. The rules, which are routine technical rules, must be amended by October 1, 2014.