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Changes to Nursing Home Principles of Reimbursement Finalized

The rule-making process for 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities is now complete. A summary of the changes that have been adopted can be reviewed here. The effective date of the changes was November 26, 2023. 
 
Maine Health Care Association provided detailed testimony on the proposed changes. The Department's response to public comments on the proposed rule changes can be found here.
 
A few highlighted changes include:
  • Principle 13.2 (Cost Reports):  The Department made two changes: (1) To comply with the Social Security Act, 42 U.S.C. Section 1320a-7k(d), if a nursing facility determines from the cost report that the nursing facility owes moneys to the Department, it must submit 100% (changed from 50%) of the amount owed to the Department with its filed cost report; and (2) In compliance with P.L. 2023, ch. 121, added a requirement that if it is determined that the Department owes the facility money, the Department must reimburse at least seventy-five percent (75%) of the settlement pursuant to the facility's cost reports within ninety (90) days of receipt.
  • Adds health savings accounts and flexible spending accounts to the list of Direct Care Cost Components.
  • Adds background checks and software costs and licensing fees to the list of allowable costs for the routine component of the rate.
  • Principle 17.4.2.6 (Purchased Central Office services): Adds “Purchased Central Office Services” to the list of Administration Functions under Routine Cost Components to clarify that Central Office services purchased from another provider are only allowable to the extent they are actual costs, as a service provided by a related party. After comments, the Department added clarifying language to the final rule, clarifying that the nursing facility providing this service to another nursing facility, would not be reimbursed for the cost of providing the service.
  • Clarifies the Motor Vehicle Allowance to state that only one vehicle per facility is allowed as a Routine Cost Component.
Again, for a more detailed overview of the rule changes as well as the final adopted version of the Principles of Reimbursement for Nursing Facilities, click here.
 
Staff contact: awesthoff@mehca.org