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Notice from the Office of MaineCare Services

A Notice from the Office of MaineCare Services
Case Managers and Providers of Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder - January 17, 2017

 

Case Managers of MaineCare Members Who Receive Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder 

Re: Respite Services 

In early 2017, respite services will be available to members who receive services through Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorde. 

The process for you will be the same as the process for any waiver service: 

  • Member/team decides which agency will provide the service
  • Agency enters service description in the member’s plan
  • Case manager sends signed face/cover sheet with Authorization Request Form
  • Resource coordinator sends the agency the prior authorization email 

The Department is requiring a vendor call before any agency is chosen, whether the member has a preference or not. The Department is also requiring that the agency arrange for the direct support professional who will be providing respite to meet the member prior to the first time respite service is provided. 

Respite has a limit per person of $1,000 per fiscal year (July 1st of one year to June 30th of the following year). Resource coordinators will track the utilization of respite services. Section 29 members must exhaust the Section 29 respite benefit prior to accessing any other funding options for respite. 

If you have questions about enrollment or authorization, please contact M. L. Owen (Mel) at: martha.l.owen@maine.gov.


Providers of Sections 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder 

Re: Respite Services within Section 29 

In early 2017, respite services will be available to members who receive services through Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder. 

If you want to provide respite services to MaineCare members who receive services through Section 29, please notify your nearest resource coordinator who will send you a “New Service” application packet, along with additional information necessary to provide respite services. To find your nearest resource coordinator, go to the

Children’s Behavioral Health – District Staff webpage and select the District Staff Contacts link for your county. 

Once your application is reviewed and approved, you can enroll a respite service location in MIHMS, and an authorization location (with matching NPI+3) will be created in EIS and should be used when billing respite claims. 

As soon as your service location is enrolled and there is a corresponding authorization location, you can respond to vendor calls for respite services. If a MaineCare member chooses your agency to provide the service, you will enter the respite service description into the member’s plan. The member’s case manager will then submit an Authorization Request Form and, if approved, you will receive a prior authorization email to provide the service. 

Respite has a limit per person of $1,000 per fiscal year (July 1st of one year to June 30th of the following year). 

If you have questions about enrollment or authorization, please contact M. L. Owen (Mel) at: martha.l.owen@maine.gov