Sec. 1. 22 MRSA §3174-FF, sub-§3, ķI is enacted to read:

I.__A member is eligible for covered services determined to be medically necessary in addition to those provided or limited under paragraphs A to H if failure to provide the services would create a substantial likelihood that the member's medical condition will deteriorate or if the provision of those services would be cost-effective in comparison to the provision of other covered medical services for the treatment of the member's medical condition.

SUMMARY

This bill provides that a member of MaineCare whose services are limited under MaineCare Basic is eligible for additional medically necessary services if failure to provide those services creates a substantial likelihood of deterioration of medical condition or if providing those services is cost-effective.