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-89 - MaineMOM Services and Reimbursement › Subsection 144-101-II-89.05 - COVERED SERVICES

Current through 2024-29, July 17, 2024
MaineMOM Services are for the perinatal period. MaineMOM
						providers shall provide the following Covered Services in accordance with the
						requirements in their respective subsections. Providers of MaineMOM Integrated
						Model Services (Section
						89.06-3) and
						MaineMOM Partnership Model Services (Section
						89.06-4) shall
						deliver all covered services. Providers of MaineMOM Perinatal Navigation Model
						Services (Section
						89.06-5) shall only
						deliver Health Home Services (Section
						89.05-1) and Access
						to Medication (Section
						89.05-4).
MaineMOM providers shall document in their EHR all
						covered services provided to members.
89.05-1
Health Home Services
The MaineMOM provider shall provide at least one of the
						following Health Home Services to each member within the reporting month,
						pursuant to the member's Care Plan. Until such time as a Care Plan is in place,
						each month's services must include Care Plan development under Section
						89.05-1(A).
Services may be delivered in any community location where
						confidentiality can be maintained, as clinically appropriate. Not all aspects
						of the covered services will require direct member involvement; however, all
						covered services require that MaineMOM provider activities be directly related
						to an individual member, are member-informed, and pursuant to the member's Care
						Plan.
A.
Comprehensive Care
					 Management
The MaineMOM provider shall complete a screening and
						comprehensive assessment and create Care Plans, Plans of Safe Care, and plans
						for labor and delivery based on the screening and comprehensive assessment with
						the member and family or other support system input if desired by the
						member.
MaineMOM providers shall use shared decision-making aids
						and consider members' health literacy levels and cultural identification in
						comprehensive assessments and care planning, in setting measurable goals as
						clinically appropriate.
MaineMOM providers shall facilitate access to prenatal,
						intrapartum, postpartum medical services in accordance with the MBM, Chapter
						II, Section
						90, Physician Services.
1.
Screening and Comprehensive
					 Assessment
Qualified MaineMOM staff shall conduct a screening and
						comprehensive assessment to determine diagnosis, the level of care in which the
						member should be placed, and to identify treatment priorities for the Care
						Plan. The MaineMOM provider shall place and maintain in the medical record for
						each MaineMOM member a comprehensive assessment report and evidence of the
						member having had an annual physical exam. A comprehensive assessment shall be
						completed at the time of intake of a new member, updated no later than thirty
						(30) days after an end of pregnancy date and reviewed when a member's needs or
						circumstances change.
a. The
					 comprehensive assessment shall include documentation of:
i. medications;
ii. allergies;
iii. family history;
iv. nutritional status;
v. education;
vi. military service (if
					 applicable);
vii. legal
					 issues;
viii. vocational
					 background;
ix. spirituality and
					 religious preferences;
x. leisure
					 and recreational activities; and
xi.
					 addiction-focused history, including patterns of use, durations or periods of
					 sobriety, and successful recovery strategies used.