Current through 2024-51, December 18, 2024
Subsection 144-101-II-40.10 - COPAYMENTA. A copayment will be charged to each MaineCare member for each day Home Health Services are provided. The amount of the copayment shall not exceed $3.00 per day for services provided, according to the following schedule: MaineCare Payment for Service Member Copayment
MaineCare Payment for Service | Member Copayment |
$10.00 or less | $ .50 |
$10.01 - 25.00 | $1.00 |
$25.01 - 50.00 | $2.00 |
$50.01 or more | $3.00 |
B. The member shall be responsible for copayments up to $30.00 per month whether the copayment has been paid or not. After the $30.00 cap has been reached the member shall not be required to make additional copayments and the provider shall receive full MaineCare reimbursement for covered services.C. No provider may deny services to a member for failure to pay a copayment. Providers must rely upon the member's representation that he or she does not have the cash available to pay the copayment. A member's inability to pay a copayment does not, however, relieve him/her of liability for a copayment.D. Providers are responsible for documenting the amount of copayments charged to each member (regardless of whether the member has made payment) and shall disclose that amount to other providers, as necessary, to confirm previous copayments. Providers are subject to the Department's copayment requirements. Refer to Chapter I, General Administrative Policies and Procedures for rules governing copayment requirements, exemptions and dispute resolution.
C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-40, subsec. 144-101-II-40.10