The fiscal years 2016-2017 biennial budget required that the Maine Department of Health and Human Services (DHHS) contract with a third party to review the rates paid for services covered under Sections 28 and 65 of the MaineCare Benefits Manual. In meeting this requirement, DHHS determined to review Sections 13 and 17, as well, providing for a comprehensive study of rates paid for behavioral health services under the MaineCare program. DHHS contracted with the national consulting firm Burns & Associates, Inc. (B&A) to conduct the rate review.
UPDATED APRIL 2017 – FINAL PROPOSED RATE MODELS FOR FORMAL RULEMAKING
The proposed rate models have been revised based on additional feedback received from providers. DHHS intends to enter into formal rulemaking to implement these rates.
• The final proposed rate models for formal rulemaking is available here
• A supplement to the December 31 Comments and Responses document outlining the additional changes to the rate models is available here
UPDATED JANUARY 2017 – FINAL PROPOSED RATE MODELS
DHHS has revised the draft rate models to incorporate feedback received during the public comment process. The revised models reflect proposed rate adjustments for 38 services (treating services with multiple codes—such as Targeted Case Management and Psychological Testing—as a single service and excluding group rates). 23 models call for rate increases; 15 call for rate reductions.
The following materials are posted:
• An Executive Summary that provides highlights from the final proposal, including changes made in response to public comments, is available here
• The Final Proposed Rate Models and related appendices are available here
• The Comment and Response Document, which provides DHHS’ response to the 144 unique comments received from more than 150 commenters is available here
UPDATED MARCH 2016 – DRAFT PROPOSED RATE MODELS
Based on the foregoing research and analysis, the Department has released proposed rate models and supporting documentation for public comment.
The following materials are available for review:
• An overview of the project and highlights of results are available here
• The proposed rate models and related appendices are available here
• An analysis of provider survey results are available here
• The provider survey form can be downloaded here and the instructions are available here