Current through 2024-51, December 18, 2024
Unless otherwise indicated, the following terms shall have the following meanings:
1. "AFDC" means the Aid to Families With Dependent Children Program.2. "Benefits" means services as set forth in the Maine Health Program Rules, Chapter III, Benefits.3. "Bureau" means the Bureau of Medical Services.4. "Department" means the Department of Human Services.5. "Eligibility Specialist" means a Department of Human Services, Bureau of Income Maintenance worker responsible for determining eligibility.6. "Employer supported plan" means a group insurance plan in which the employer makes a contribution on behalf of employees and/or their dependents.7. "Federal poverty guidelines" means the federal poverty levels established as required by the United States Omnibus Budget Reconciliation Act of 1981, Public Law 97-35, Sections 652 and 673(2), as periodically updated.8. "Medicaid" means the program administered by the Department that provides medical assistance to eligible individuals as set forth in Title XIX.9. "Premium" means a fee which is required to be paid in order to receive "transition" benefits or the amount the Department contributes toward the recipient's employer-supported health insurance plan, as the context indicates.10. "Primary Care Case Management" is a system wherein primary care providers enter into a written agreement with the Department to deliver or arrange for delivery of a specific set of health care services for a panel of participants.11. "Program. means Maine Health Program. This includes the "basic" Program for recipients whose income is at or below 100% of the federal poverty guidelines and the "transition" Program for recipients whose income is more than 100% but less than or equal to 150% of the federal poverty guidelines.12. "Recipient" means an individual enrolled in the Program.13. "SSI" means Supplemental Security Income. C.M.R. 10, 144, ch. 103, I