Subsection 144-101-II-91.05 - POLICIES AND PROCEDURES91.05-1Member IdentificationMembers may request CCT or HOME services or be referred for CCT or HOME services from any point-of-care at which the Member's needs for CCT or HOME services are identified.
CCTs and HOME Providers shall accept referrals and assess Members who are potentially eligible for covered services based on the eligibility criteria in 91.03 and 91.04. CCTs and HOME Providers shall enroll qualifying Members for CCT or HOME services.
91.05-2Enrollment and Duplication of Services1.Enrollment. CCTs and HOME Providers shall give potentially eligible Members information about the benefits of receiving CCT or HOME services. The Member can choose to be part of a CCT or HOME Provider once confirmed eligible. The Member shall be approved for services effective the earliest date without risk of duplicative services. The Member can choose to not participate at any time by notifying their CCT or HOME Provider or the Department.2.Duplication of Services. The Department will not reimburse for duplicative services for Members. A Member may only receive services from one CCT or HOME Provider at any given time. If, through the enrollment process, the Member is determined to be receiving a duplicative service, the Member shall choose which service they want to receive. CCTs and HOME Providers shall provide Members with notice that the Members cannot receive duplicative services. The Member's choice of services will be retained in the Member's EHR. CCT or HOME Provider services do not preclude a Member from receiving other medically necessary services.
Members may not receive CCT or HOME services that duplicate services from other sections of the MaineCare Benefits Manual, including the following services:
a. Section 13: Targeted Case Management Servicesb. Section 17.04-1: Community Integration Servicesc. Section 17.04-2: Community Rehabilitation Servicesd. Section 17.04-3: Assertive Community Treatmente. Section 46: Psychiatric Hospital Services (except as described 91.08-2)f. Section 67: Nursing Facility Services (except as described 91.08-2)g. Section 92: Behavioral Health Home Servicesh. Section 93: Opioid Health Home Services MaineCare services that are covered concurrently with HOME services only for a thirty (30) day overlap from the date of admission or sixty (60) day overlap prior to the date of discharge to allow for comprehensive transitional care include:
i. Section 46: Psychiatric Hospital Servicesii. Section 67: Nursing Facility Services3.Consent Forms: CCTs and HOME Providers shall retain a signed consent form for all CCT and HOME Provider Members in the Member record. For children receiving services, CCTs and HOME Providers shall retain a signed consent form from a parent or legal guardian. Consent documentation must, at a minimum:a. Indicate that the Member or parent or legal guardian has received information in writing, and verbally as appropriate, explaining the CCT or HOME Provider purpose and the services provided; andb. Indicate that the Member or parent or legal guardian has consented in writing, and verbally as appropriate, to receive the CCT or HOME services and understand their right to choose, change, or disenroll from their CCT or HOME Provider at any time. C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-91, subsec. 144-101-II-91.05