C.M.R. 10, 144, ch. 104, § 144-104-7, subsec. 144-104-7.05

Current through 2024-51, December 18, 2024
Subsection 144-104-7.05 - COVERED SERVICES

The Department shall provide coverage to MaineCare members for Abortion services that are not covered or reimbursed by Medicaid, including medical services and supplies incidental or preliminary to an Abortion, when performed by a Health Care Professional in a licensed general hospital or outpatient setting.

A. Health Care Professional/surgical charges for performing the Abortion. These charges include the usual, uncomplicated pre- and post-operative care and visits related to performing the Abortion.
B. Hospital or clinic charges associated with the Abortion. This includes the facility fee for use of the operating room; supplies and drugs necessary to perform the Abortion; and charges associated with routine, uncomplicated pre- and post-operative visits by the patient.
C. Medication Abortions.
D. Health Care Professional charges for administering the anesthesia necessary to induce or perform an Abortion.
E. Drug charges for medication usually provided to or prescribed for the patient who undergoes an uncomplicated Abortion. This includes routinely provided oral analgesics and antibiotics to prevent septic complication of Abortion, and Rho-GAM.
F. Charges for histo-pathological laboratory tests performed routinely.
G. Charges for other laboratory tests performed prior to performing the Abortion to determine the anesthetic/surgical risk of the patient (e.g., CBC, electrolytes, blood typing).
H. Ultra sounds related to the Abortion.
I. One follow-up visit/exam occurring within 30 days from the date of the Abortion.

C.M.R. 10, 144, ch. 104, § 144-104-7, subsec. 144-104-7.05