‘Resolve, Directing the Department of Health and Human Services To Review Rules Governing Reimbursement to MaineCare Recipients for Transportation to and from MaineCare Services’

‘Sec. 1. Review; rules. Resolved: That the Department of Health and Human Services shall review reimbursement under the MaineCare program for transportation of MaineCare members to and from MaineCare services, including but not limited to methadone treatment services at freestanding methadone clinics, in order to improve consistency across the State, to prevent and detect fraud and to decrease costs to the MaineCare program. The department shall report to the joint standing committee of the Legislature having jurisdiction over health and human services matters by December 15, 2012 the results of its review, including recommendations for action by the department and the Legislature.

In conducting the review required by this resolve, the department shall:

1. Solicit input from health care providers, the MaineCare advisory committee within the Department of Health and Human Services, regional transportation providers and freestanding methadone clinics throughout the State regarding potential use of transportation brokers across the State, protocols used to confirm member eligibility for transportation services, methods for arranging, scheduling and verifying the use of transportation services, methods to obtain patient consent and methods for sharing information among the patient, the health care provider or the freestanding methadone clinic, the transportation provider and the office of MaineCare services within the Department of Health and Human Services;

2. Solicit input from district attorneys regarding any instances of suspected or confirmed fraud in MaineCare reimbursement for transportation to and from health care providers and methadone treatment services at freestanding methadone clinics;

3. Review the requirements for member eligibility for transportation services, including verification of the member's place of residence, transportation reimbursement that is limited to the closest health care provider, requirements for requesting and scheduling transportation services and options and procedures for terminating transportation reimbursement for a member who violates department rules or requirements of a health care provider or freestanding methadone clinic;

4. Review, establish a timeline for and report on progress toward a regional transportation system for serving MaineCare members that uses transportation brokers, pays a flat rate per month per MaineCare member to the transportation broker and provides some degree of standardization across the State; and

5. Review options for limiting transportation reimbursement allowable under federal law and regulation and options for coordinating transportation services in order to decrease costs when transportation is needed for more than one type of MaineCare service.’