LD 1919
pg. 233
Page 232 of 267 PUBLIC Law Chapter 673 Page 234 of 267
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LR 2833
Item 1

 
2.__Rules.__The department shall adopt rules to implement
MaineCare Basic in accordance with this section.__Rules adopted
pursuant to this section are routine technical rules as defined
in Title 5, chapter 375, subchapter 2-A.

 
3.__Services.__The rules adopted pursuant to subsection 2 must
provide for access to medically necessary services as provided in
the federally approved Medicaid state plan.__Benefits for certain
services are limited as follows.

 
A.__A member is eligible for speech therapy benefits if the
member has been assessed to have rehabilitation potential
and has been documented by a physician to have experienced a
significant decline in ability to communicate orally, safely
swallow or masticate.__Speech therapy benefits must cover
one initial evaluation of the member per provider per year
and one reevaluation every 6 months per provider.__Speech
therapy benefits must cover outpatient therapy provided in
the home, independent practitioners' offices and speech and
hearing clinic sites.

 
B.__A member is eligible for rehabilitation services
benefits for brain injury subject to levels of care
determined by rule.

 
C.__A member is eligible for psychological services benefits
for individual and group counseling.__Benefits for one or
both types of counseling combined are limited to a total of
16 one-hour visits per year.

 
D.__A member is eligible for benefits for durable medical
equipment, prosthetics and orthotics for one pair of shoes
and one pair of inserts per year, medical supplies required
to meet standard daily needs and power wheelchairs for a
member who is nonambulatory and has a significant
neuromuscular disease or disorder.

 
E.__A member is eligible for occupational and physical
therapy benefits provided by occupational and physical
therapists licensed under Title 32 and who are acting within
their scope of practice.__Services of occupational and
physical therapists may be provided in all outpatient
settings, including the home.__For services subject to this
paragraph, the department may require a member to have that
member's rehabilitation potential documented by a physician
and may limit treatment to:

 
(1)__Treatment following an acute hospital stay for a
condition affecting range of motion, muscle strength
and physical functional abilities;


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