C.M.R. 10, 144, ch. 101, ch. IV, § 144-101-IV-1, subsec. 144-101-IV-1.06

Current through 2024-51, December 18, 2024
Subsection 144-101-IV-1.06 - PLAN MONITORING

During the period of enrollment in the Restriction Plan, the Program Integrity Unit will supervise and monitor utilization patterns of restricted members and analyze computer-generated profiles of the member's health care services reimbursed under MaineCare. The member will be contacted by the Program Integrity Unit periodically to verify that his or her medical needs are being met.

The member shall receive the Program Integrity Unit's toll-free telephone number, to clarify questions regarding restriction, seek assistance if access problems arise, and report complaints.

C.M.R. 10, 144, ch. 101, ch. IV, § 144-101-IV-1, subsec. 144-101-IV-1.06