C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-97, subsec. 144-101-II-97.09
For each MaineCare provider enrolled as a participating Private Non-Medical Institution, the Department will determine an interim per diem rate, as determined under Chapter III, Section 97, Principles of Reimbursement for Private Non-Medical Institution Services, and the applicable Appendix.
Providers are required to obtain separate MaineCare provider number(s) for each PNMI provider type as described in Section 97.01-1. Upon completion of the provider's fiscal year, the providers shall submit to the Department, a cost report for each PNMI that has been assigned a provider number(s) in accordance with Chapter III of the Principles of Reimbursement.
Agencies that obtain public funds from another source to use as either a portion or as the entire State share of the PNMI rate must complete a Rider A as part of their Provider/Supplier Agreement to certify the State share of MaineCare funding. If certified public funds support only a portion of the PNMI rate, the full rate must be paid to the provider, with an adjustment made at settlement to reimburse the Department the amount certified in Rider A. This amount will be reported to the Department using Chapter III, Section 97 rules for the submission of cost reports.
In accordance with Chapter I of the MaineCare Benefits Manual, it is the responsibility of the provider to seek payment from any other resources that are available for payment of the rendered service prior to billing MaineCare.
C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-97, subsec. 144-101-II-97.09