C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-103, subsec. 144-101-II-103.01

Current through 2024-51, December 18, 2024
Subsection 144-101-II-103.01 - DEFINITIONS
103.01-1Covered Services are those services described in 103.04 for which payment can be made under Title XIX and Title XXI by the Department of Health and Human Services.
103.01-2A Homebound Member is an individual who is permanently or temporarily confined to his or her place of residence because of a medical or health condition. The individual may be considered homebound if he or she leaves the place of residence infrequently. For this purpose, "place of residence" does not include a hospital or long term care facility.
103.01-3Plan of Treatment is a written plan of medical services for part-time or intermittent visiting nurse care that is established and reviewed at least every sixty (60) days by a supervising physician of the clinic. When delegated by the supervising physician, and when in compliance with all other State licensure requirements it may also be established by a physician assistant, nurse practitioner, nurse midwife, or clinical nurse specialist and reviewed and approved at least every sixty (60) days by a supervising physician of the clinic.
103.01-4Primary Health Care refers to preventative, diagnostic and therapeutic services furnished by the clinic's professional staff and, where appropriate, the supplies commonly used to support those services, basic laboratory services essential for diagnosis and treatment, and emergency medical care for the treatment of life-threatening injuries and acute illness.
103.01-5Rural Health Clinic means a Primary Health Care clinic that is both certified as a Rural Health Clinic by Medicare and enrolled as a MaineCare provider. A clinic may be either a provider based clinic or an independent clinic.
A. A provider-based clinic exists when:
1. the clinic is an integral part of an existing hospital, skilled nursing facility, or home health agency participating in Medicare; and
2. the clinic is operated with other departments of the provider under common licensure, governance, and professional supervision.
B. An independent clinic is a Rural Health Clinic operating as a separate entity.
103.01-6Rural Health Clinic Services are those Primary Health Care services furnished by the facility's professional staff during a visit.
103.01-7A Unit of Rural Health Clinic Service is a visit that includes a face-to-face contact with one or more of the clinic's health professional staff and, where appropriate, receipt of appropriate supplies, treatments, and laboratory services.
103.01-8Incidental Supplies and Servicesrefer to certain services and supplies authorized by licensed medical, dental and mental health practitioners.

C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-103, subsec. 144-101-II-103.01