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MaineCare Benefits Manual, Chapter II, Section 96 (Private Duty Nursing and Personal Care Services), Subsection 96.05 - Non-Covered Services (10-144 C.M.R. ch. 101, § 144-101-II-96.05)
MaineregulationMaine Department of Health and Human Services, Office of MaineCare Services
What this rule requires your agency to do
- 1Services not approved by the plan of care are not reimbursable (§ 96.05(N)).(MaineCare Benefits Manual, Chapter II, Section 96 (Private Duty Nursing and Personal Care Services), Subsection 96.05 - Non-Covered Services (10-144 C.M.R. ch. 101, § 144-101-II-96.05))
- 2Services in excess of 40 hours per week, provided by an individual PSS, home health aide or certified nursing assistant, for an individual Member are not reimbursable (§ 96.05(O)).(MaineCare Benefits Manual, Chapter II, Section 96 (Private Duty Nursing and Personal Care Services), Subsection 96.05 - Non-Covered Services (10-144 C.M.R. ch. 101, § 144-101-II-96.05))
- 3Personal care services provided by a spouse of the Member, the parents or stepparents of a minor child, or a legally responsible relative are not reimbursable (§ 96.05(E)).(MaineCare Benefits Manual, Chapter II, Section 96 (Private Duty Nursing and Personal Care Services), Subsection 96.05 - Non-Covered Services (10-144 C.M.R. ch. 101, § 144-101-II-96.05))
Applies to: personal care
Enumerates services that are not reimbursable under Section 96, including a 40-hour-per-week per-worker cap and prohibitions on personal care by legally responsible relatives and on services not approved in the plan of care.
Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.