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 III - Allowances for Services › Section 144-101-III-45 - HOSPITAL SERVICES › Subsection 144-101-III-45.08 - SUPPLEMENTAL POOL FOR NON-CRITICAL ACCESS HOSPITALS, HOSPITALS RECLASSIFIED TO A WAGE AREA OUTSIDE MAINE AND REHABILITATION HOSPITALS

Current through 2024-29, July 17, 2024
The Department will allocate a supplemental pool for each
						state fiscal year among the privately owned and operated Acute Care
						Non-Critical Access hospitals, hospitals reclassified to a wage area outside
						Maine by the Medicare Geographic Classification Review Board and rehabilitation
						hospitals. Allocations will not exceed the total supplemental pool amount and
						not exceed allowable aggregate upper payment limits. Total annual supplemental
						pool amounts are available on the MaineCare Services website; or, interested
						parties may request a paper copy by calling (207) 624-4050 or Maine Relay
						number 711.
45.08-1
Inpatient
					 Pool
. Effective November 14, 2019, the allocated inpatient pool amount
					 will be distributed based on each hospital's relative share of inpatient
					 MaineCare payments, defined as the hospital's inpatient MaineCare payment in
					 the applicable hospital fiscal year divided by inpatient
MaineCare payments made to all privately owned and
						operated Acute Care Non-Critical Access hospitals, hospitals reclassified to a
						wage area outside Maine by the Medicare Geographic Classification Review Board,
						and rehabilitation hospitals for the same period; multiplied by the
						supplemental pool. For state fiscal years beginning on or after July 1, 2019,
						but before July 1, 2021, the hospital's year is the hospital's fiscal year that
						ended during calendar year 2016.
45.08-2
Outpatient Pool
.
					 Effective November 14, 2019, the allocated outpatient pool amount will be
					 distributed based on each hospital's relative share of outpatient MaineCare
					 payments, defined as the hospital's outpatient MaineCare payment in the
					 applicable hospital fiscal year divided by outpatient MaineCare payments made
					 to all privately owned and operated
Acute Care Non-Critical Access hospitals, hospitals
						reclassified to a wage area outside Maine by the Medicare Geographic
						Classification Review Board, and rehabilitation hospitals for the same period;
						multiplied by the supplemental pool. For state fiscal year beginning on or
						after July 1, 2019, but before July 1, 2021, the hospital's applicable year is
						the hospital's fiscal year that ended during calendar year 2016.
Each hospital in the pool will receive its relative share
						of this supplemental payment. Supplemental payments will be distributed
						semiannually in November and May.
This pool will be decreased by the amount a hospital
						would have received if that hospital was in the pool when the total pool amount
						was set and subsequently becomes an approved critical access hospital.
This supplemental pool payment is not subject to cost
						settlement.