NOTICE OF MAINECARE 1115 WAIVER APPLICATION
AGENCY: Department of Health and Human Services, Office of MaineCare Services
PUBLIC HEARINGS: Pursuant to 42 CFR Part 431.408, notice is hereby given that the Department of Health and Human Services ("DHHS") will host two public hearings on the DHHS 1115 waiver application that will be submitted to the Centers for Medicare and Medicaid Services ("CMS").
Hearing 1: Augusta Public Hearing
Date: Wednesday, April 19, 2017
Time: 8:00am
Location: Augusta Civic Center
76 Community Drive
Augusta, Maine 04330
Conference Line: 1-877-455-0244
Passcode: 7319892834
Hearing 2: Portland Public Hearing
Date: Tuesday, April 25, 2017
Time: 8:00am
Location: Italian Heritage Center
40 Westland Avenue
Portland, Maine 04102
Conference Line: 1-877-455-0244
Passcode: 7319892834
This waiver seeks to implement the changes below. More information about the proposed waiver amendment, including the proposed waiver application and the full public notice, can be found at: http://www.maine.gov/dhhs/oms/rules/demonstration-waivers.shtml.
Require able-bodied adults to meet community engagement and work requirements. There are numerous ways to meet this requirement. In addition, individual exemptions may be granted based on the criteria described in the full waiver application. Non-pregnant members who fail to meet the community engagement and work requirements will be dis-enrolled from MaineCare until compliance is achieved.
Cease to provide non-emergency transportation to optional Medicaid services, with the exception of home and community-based waiver services. This would apply to members over the age of twenty-one (21) who are currently eligible for non-emergency transportation services.
Require able-bodied adults to pay monthly premiums. Premiums will be tiered based on income. Non-pregnant members who do not pay their premiums will be dis-enrolled from MaineCare until premiums are paid.
Require all members to pay a $20 co-payment for non-emergency use of the emergency department.
Allow MaineCare providers to charge any MaineCare member for missed appointments.
Apply a reasonable asset test to MaineCare eligibility determinations for members not otherwise subject to asset tests.
Waive the prohibition of imposing a transfer penalty for the purchase of Medicaid-compliant annuities for long-term care coverage determinations and institute reasonable minimum pay out periods for the annuitant.
Cease to provide retroactive coverage for any person applying for MaineCare coverage. Coverage would begin on the first day of the month in which an application is received.
Eliminate the option for hospitals to make presumptive eligibility determinations.
The goals of this 1115 waiver are (1) to preserve limited financial resources for the State's most needy individuals and ensure long-term fiscal sustainability; (2) to promote financial independence and transitions to employer sponsored or other commercial health insurance; (3) to encourage individual responsibility for one's health and health care costs.
PUBLIC COMMENT: This notice also serves to open the 30-day public comment period, which closes at 11:59PM on May 11, 2017.
Comments and questions about the proposed 1115 waiver application can also be submitted online via: http://www.maine.gov/dhhs/oms/rules/demonstration-waivers.shtml or by mail to: Division of Policy/MaineCare Services, 242 State St. 11 State House Station, Augusta, Maine 04333-0011. All comments must be received by 11:59PM May 11, 2017.
The public may review the proposed waiver application at any Maine DHHS office in every Maine County. To find out where the Maine DHHS offices are, call 1-800-452-1926.
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