C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-107, subsec. 144-101-II-107.11

Current through 2024-44, October 30, 2024

Subsection 144-101-II-107.11 - REIMBURSEMENT

107.11-01Principles of Reimbursement. The PRTF Principles of Reimbursement are specified in the MaineCare Benefits Manual, Chapter III, Section 107.

For each MaineCare provider enrolled as a participating Psychiatric Residential Treatment Facility, the Department will determine a prospective per diem rate for routine and fixed costs, as determined under Chapter III, Section 107, Principles of Reimbursement for Psychiatric Residential Treatment Facilities. Medical, clinical, and direct care services are reimbursed per diem as described in Chapter III, Section 107, Principles of Reimbursement for Psychiatric Residential Treatment Facilities Providers are required to obtain separate MaineCare provider number(s) for each PRTF. Upon completion of the provider's fiscal year, the providers shall submit to the Department, a cost report for each PRTF that has been assigned a provider number(s) in accordance with Chapter III of the Principles of Reimbursement.

A. In accordance with Chapter I of the MaineCare Benefits Manual, it is the responsibility of the provider to seek from any other sources payment for the rendered service prior to billing the MaineCare Program.

B. Psychiatric Residential Treatment Facilities may not accept or receive payment for covered services in addition to the MaineCare payment.

C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-107, subsec. 144-101-II-107.11