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-43 - Hospice Services › Subsection 144-101-II-43.01 - DEFINITIONS

Current through 2024-29, July 17, 2024
43.01-1
Attending Physician
must
					 be a medical doctor of medicine or osteopathy, nurse practitioner, or physician
					 assistant licensed to practice in the State of Maine (or the state in which the
					 services are provided). The Attending Physician provides services within the
					 scope of practice of his or her profession as defined by Maine (or applicable
					 law), identified by the member at the time he or she elects to receive hospice
					 care as having the most significant role in the determination and delivery of
					 the member's medical care.
43.01-2
Benefit Period
is the time period of consecutive days during which
					 medical benefits for covered services, within certain maximum limits, are
					 available to the Member.
43.01-3
Department
means the Maine Department of Health and Human
					 Services.
43.01-4
Hospice
is any public, private or non-profit organization, or a
					 subdivision of such an organization, that is primarily engaged in providing
					 pain relief, symptom management, and support services to terminally ill members
					 and their families. For a hospice to receive MaineCare reimbursement, it must
					 be Medicare-certified and licensed under applicable state or provincial
					 law.
43.01-5
Hospice
					 Services
are a range of interdisciplinary services provided twenty four
					 (24) hours a day, seven days a week to a person who is terminally ill and to
					 that person's family. These services are to be delivered in the least
					 restrictive setting possible by volunteers and professionals who are trained to
					 help the member with physical, social, psychological, spiritual and emotional
					 needs related to the terminal illness with the least amount of technology
					 possible. Services are focused on pain relief and symptom management and are
					 not curative in nature.
43.01-6
Interdisciplinary Team
is the team that manages the hospice
					 services provided to the terminally ill member and the member's family. The
					 team includes at least the following individuals: a doctor of medicine or
					 osteopathy, a physician assistant, a registered nurse, a medical social worker
					 and a counselor as outlined in Section
					 43.06-3. All
					 individuals must be employees of the hospice, except the physician who may be a
					 contractor of the hospice.
43.01-7
Medical Director
must be a hospice employee or contractor who is a
					 doctor of medicine or osteopathy licensed in the state in which services are
					 provided, who has overall responsibility for the medical component of patient
					 care at the hospice.
43.01-8
Representative
is an individual authorized under state or
					 provincial law to end medical care or to elect or revoke the election of
					 hospice care on behalf of a terminally ill member who is mentally or physically
					 incapacitated. For purposes of making health care decisions, a member's
					 representative may also be a "guardian," "agent" or "surrogate," as these terms
					 are defined in
					 18-C
					 MRS §5-802.
43.01-9
Terminal Illness
is a
					 medical condition resulting in a prognosis that a member has a life expectancy
					 of six (6) months or less if the illness runs its normal course.