C.M.R. 10-144 Ch. 101, Ch. II, Section 96.07 - MaineCare Benefits Manual, Private Duty Nursing and Personal Care Services, Policies and Procedures (Assessment)

What this rule requires your agency to do

• 1The provider must submit the completed MED assessment tool to MaineCare Services, Quality Improvement Division within 72 hours of completion. (144-101-II-96.07-2.A)(C.M.R. 10-144 Ch. 101, Ch. II, Section 96.07 - MaineCare Benefits Manual, Private Duty Nursing and Personal Care Services, Policies and Procedures (Assessment))
• 2The provider must conduct a reassessment and obtain prior approval of services at least 5 days prior to and no later than the reclassification date. (144-101-II-96.07-2.A)(C.M.R. 10-144 Ch. 101, Ch. II, Section 96.07 - MaineCare Benefits Manual, Private Duty Nursing and Personal Care Services, Policies and Procedures (Assessment))
• 3The provider must have the member's specific needs for medical services reviewed and approved by the member's physician at least every 62 days, and document this in the medical record and nursing plan of care by the RN. (144-101-II-96.07-1.E)(C.M.R. 10-144 Ch. 101, Ch. II, Section 96.07 - MaineCare Benefits Manual, Private Duty Nursing and Personal Care Services, Policies and Procedures (Assessment))
• 4The provider (Department, ASA, or PDN provider, as applicable) must conduct the eligibility assessment using the Department's approved MED assessment form. (144-101-II-96.07-1)(C.M.R. 10-144 Ch. 101, Ch. II, Section 96.07 - MaineCare Benefits Manual, Private Duty Nursing and Personal Care Services, Policies and Procedures (Assessment))
• 5The provider must ensure the individual conducting the assessment is a registered nurse trained in conducting assessments and developing an authorized plan of care with the Department's approved tool. (144-101-II-96.07-1.B)(C.M.R. 10-144 Ch. 101, Ch. II, Section 96.07 - MaineCare Benefits Manual, Private Duty Nursing and Personal Care Services, Policies and Procedures (Assessment))