C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-29, subsec. 144-101-II-29.06

Current through 2024-51, December 18, 2024
Subsection 144-101-II-29.06 - NON COVERED SERVICES

Services for which reimbursement is not allowed under this Section include, but are not limited to, the following:

29.06-1 Services not identified by the Personal Plan;
29.06-2 Services to any MaineCare member who receives services under any other federally approved MaineCare Home and Community based waiver program;
29.06-3 Services to any member who is a nursing facility resident, or ICF/IID resident, psychiatric hospital resident, or hospital resident;
29.06-4 Services that are reimbursable under any other sections of the MaineCare Benefits Manual;
29.06-5 Any service otherwise reimbursable under the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Act, including but not limited to job development and vocational assessment or evaluations;
29.06-6 Room and board; The term "room" means shelter type expenses, including all property related costs such as rental or purchase of real estate and furnishings, maintenance, utilities, and related administrative services. The term "board" means three meals a day; or any other full nutritional regimen. Board does not include the provision of a meal at an adult day health or similar facility outside the member's home. Board also does not include the delivery of a single meal to a member at his/her own home through a meals-on-wheels service;
29.06-7 Work Support-Individual or Work Support-Group or Employment Specialist Services when the member is not engaged in employment;
29.06-8 Home Accessibility Adaptations unless the service has been determined non-reimbursable under Medical Supplies and Durable Equipment, Section 60 or other sections of the MaineCare Benefits Manual;
29.06-9 A member may not have wages from employment paid for with MaineCare reimbursement: and
29.06-10 Services provided directly or indirectly by the legal guardian will not be reimbursed unless the legal guardian is the member's parent, sibling or other biological family member. This rule will not be avoided by adult adoption.

C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-29, subsec. 144-101-II-29.06