Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter II - Specific Policies By Service › Section 144-101-II-19 - Home and Community Benefits for the Elderly and Adults with Disabilities › Subsection 144-101-II-19.04 - COVERED SERVICES

Current through 2024-29, July 17, 2024
All covered services must be provided in accordance with
						all state and federal laws, including but not limited to requirements in
						42 C.F.R. §
												441.301(c). Covered services
						are available for members meeting the eligibility requirements set forth in
						Section
						19.02. Covered
						services must be required in order to maintain the member's current health
						status, or prevent or delay deterioration of a member and/or avoid long-term
						institutional care. Services under this Section require prior approval by the
						Department, or its Assessing Services Agency (ASA), and are included in the
						calculation of the member's program cap. Services shall not be reimbursed until
						both medical and financial MaineCare eligibility have been approved. Members
						who meet the eligibility requirements for services under this Section are
						eligible for the following services, as included by the ASA in the Authorized
						Plan of Care:
19.04-1
Assistive
					 Technology Device and Services
means devices and services that are used
					 to increase, maintain, or improve a member's functional capabilities to perform
					 Activities of Daily Living or Instrumental Activities of Daily Living. An
					 Assistive Technology Device may include an item, piece of equipment or product,
					 whether acquired commercially, modified, or customized. An Assistive Technology
					 Service means a service that directly assists a member in the selection,
					 acquisition, or use of an Assistive Technology Device.
Assistive Technology Services include:
A. services consisting of purchasing,
					 leasing, or otherwise providing for the acquisition of Assistive Technology
					 devices for members; and
B.
					 services consisting of selecting, designing, fitting, customizing, adapting,
					 applying, maintaining, repairing, or replacing Assistive Technology device.
This service will only be authorized when the requested
						equipment and supplies are medically necessary, improve or maintain the
						member's level of independence, ability to access needed supports and services
						in the community or if required to ensure a member's health and welfare. All
						other reimbursement of Assistive Technology must be explored and utilized,
						including all Medicaid State Plan services, prior to reimbursement of Assistive
						Technology services under this Section. Documentation must describe how the
						member's expected use, purpose and intended place of use have been matched to
						features of the products requested in order to achieve the desired outcome in
						an efficient and cost-effective manner.
Examples of items that may be covered are
						voice-activated, motion-activated and electronic devices, communication devices
						and mobility devices.
Vehicle modifications are excluded under this Section.
						Examples of other items that are excluded are recreation or quality of life
						items, such as televisions, microwave ovens and other general household
						appliances.
This need maybe identified by the ASA at the time of
						assessment or upon a service need referral by the Service Coordination Agency
						(SCA), subject to the service limits of this Section. The SCA will make a
						referral to the Waiver Services Provider (WSP), who will be responsible for the
						coordination, implementation and oversight of the service. A thorough
						evaluation of all Assistive Technology will be completed prior to service
						delivery by the WSP and Assistive Technology consultants, if
						appropriate.