C.M.R. 10, 144, ch. 101, ch. I, § 144-101-I-5, subsec. 144-101-I-5.01
On January 31, 2020, the Secretary of the United States Department of Health and Human Services (the "Secretary") declared a public health emergency (the "Public Health Emergency") due to COVID-19. On March 13, 2020, the President of the United States issued a proclamation that the COVID-19 outbreak in the United States constitutes a national emergency (the "Federal Proclamation of Emergency"). On March 13, 2020, pursuant to Section 1135(b) of the Social Security Act (the "Act"), the Secretary invoked his authority to waive or modify certain requirements of titles XVIII, XIX, and XXI of the Act as a result of the consequences of the COVID-19 pandemic, to the extent necessary, as determined by the Centers for Medicare & Medicaid Services (CMS). The waivers and modifications of the Act shall no longer be in effect upon termination of either the Public Health Emergency or the Federal Proclamation of Emergency, including any extensions.
Maine Governor Janet T. Mills proclaimed a state of emergency due to COVID-19 on March 15, 2020, which was extended by further proclamation on April 14, 2020. On April 28, 2020, the Governor issued Executive Order No. 48 FY 19/20, An Order Modifying Certain Procedural Requirements for Emergency Rulemaking to Maximize Federal COVID-19 Funding for MaineCare (the "Executive Order"). Pursuant to 5 M.R.S. §§ 8054 and 8073, and the Executive Order, this single emergency rulemaking implements temporary changes to various sections of the MaineCare Benefits Manual (MBM) in order to expedite and improve access to medical care for MaineCare members in light of the substantial public health threat posed by COVID-19. The following sections of MaineCare policy are affected by this rulemaking: Ch. 1, Section 1 (General Administrative Policies and Procedures); Ch. I, Section 4 (Telehealth Services); Ch. II, Section 17 (Community Support Services); Chs. II and III, Section 31 (Federally Qualified Health Center Services); Chs. II and III Section 40 (Home Health Services); Chs. II and III, Section 45 (Hospital Services); Ch. II, Section 55 (Laboratory Services); Ch. II, Section 60 (Medical Supplies and Durable Medical Equipment); Chs. II and III, Section 65 (Behavioral Health Services); Ch. II, Section 67 (Nursing Facility Services); Ch. II, Section 80 (Pharmacy Services); Ch. II, Section 90 (Physician Services); Ch. II, Section 94 (Early and Periodic Screening, Diagnostic and Treatment Services (EPSDT)); Chs. II and III, Section 96 (Private Duty Nursing and Personal Care Services); Chs. II and III, Section 97 (Private Non-Medical Institution Services); Ch. II, Section 101 (Medical Imaging); Chs. II and III, Section 103 (Rural Health Clinic Services); Ch. X, Section 1 (Benefit for People Living with HIV/AIDS); Ch. X, Section 3 (Katie Beckett Benefit).
In the event of conflict between the COVID-19 Public Health Emergency Services rule and any other MaineCare rule, the terms of this rule supersede other rules and shall apply.
Except as otherwise noted herein, CMS approved of these changes through, inter alia, (a) a Section 1135 Waiver, approved on April 7, 2020, which is generally effective March 1, 2020; (b) a Disaster State Plan Amendment (SPA), approved April 24, 2020, which is generally effective March 1, 2020; and (c) various blanket waivers of the Act and CMS guidance regarding same. Unless otherwise noted herein, these changes shall be effective retroactive to March 18, 2020.
The Executive Order suspended and modified the relevant provisions of the MAPA in order for these rule changes to:
C.M.R. 10, 144, ch. 101, ch. I, § 144-101-I-5, subsec. 144-101-I-5.01