Demonstration Waivers

 

Privacy Information

Your health information is protected.

Skip to IMD Exclusion Waiver

Section 1115 HIV Demonstration Waiver
Post-Award Public Forum

Overview

In April 2019, the Maine Medicaid Section 1115 Demonstration for Individuals with HIV/AIDS was granted a 10-year approval from the Centers for Medicare and Medicaid Services (CMS). This waiver has been operational since July 1, 2002, and it provides a defined set of MaineCare services to individuals living with HIV/AIDS who have an individual income equal to or less than 250% of the Federal Poverty Level (FPL) and are not otherwise eligible for MaineCare. This waiver is designed to provide more effective, early treatment of HIV by making available a limited but comprehensive package of services, including antiretroviral therapies. The State believes that early treatment and care management services provided to individuals with HIV/AIDS create efficiencies that allow MaineCare to help individuals maintain access to critical treatments, keeping the disease from progressing.

This waiver aims to improve the health status of individuals living with HIV/AIDS in Maine by:

  • Improving access to continuous healthcare services;
  • Arresting progression of HIV/AIDS status by providing early and optimal care coupled with high quality and cost efficiency; and
  • Using the savings generated from disease prevention and the delayed onset of AIDS to expand coverage to additional low-income individuals living with HIV.

Post-Award Forum Information

Date: September 11, 2019
Time: 9:00 AM
Location: Maine A & B Conference Room
State Office Building
109 Capitol Street
Augusta, ME 04330
Conference Line: 1-877-455-0244
Passcode: 7155869880
   

Section 1115 HIV Demonstration Waiver Post-Award Documents

Section 1115 HIV Demonstration Waiver Post-Award Written Comments

Comments will be accepted through 11:59 p.m. on September 20, 2019. Written comments may be submitted in the following ways:

  1. By email to: Policy.DHHS@maine.gov
  2. By mail to: Division of Policy/MaineCare Services, 109 Capitol Street, 11 State House Station, Augusta, ME 04333-0011

IMD Exclusion for SUD and SMI/SED

Overview

The State of Maine’s Department of Health and Human Services is seeking waiver authority under Section 1115 to claim Federal Financial Participation (FFP) for the medically necessary services provided to eligible individuals ages 21-64 with a Substance Use Disorder (SUD), Serious Mental Illness (SMI) and/or children with Serious Emotional Disturbance (SED), residing in facilities meeting the regulatory definition of an Institute for Mental Disease (IMD). Current Medicaid statue does not allow FFP for care or services for any individual who has not attained 65 years of age and who is a patient in an IMD. This restriction is known as Medicaid’s IMD exclusion. This 1115 waiver will provide the state flexibility in the service delivery system with the aim of expanding access to treatment modalities and bridging medical and behavioral health needs to ensure a full continuum of care for people with SUD and SMI/SED.

IMD Exclusion for SUD and SMI/SED Public Hearings

Hearing 1: Augusta Public Hearing
Date: March 6, 2019
Time: 10:00 AM
Location: 111 Sewall Street, Rm. 103A&B
  Augusta, ME 04330
Conference Line: 1-877-455-0244
Passcode: 7319892834
   
Hearing 2: Portland Public Hearing
Date: March 7, 2019
Time: 10:00 AM
Location: 151 Jetport Blvd., Rm 139A&B
  Portland, ME 04101
Conference Line: 1-877-455-0244
Passcode: 7319892834

IMD Exclusion for SUD and SMI/SED Waiver Documents

IMD Exclusion for SUD and SMI/SED Written Comments

Written comments on the proposed changes are welcome and will be accepted from February 22, 2019, through 11:59PM on March 25, 2019. Written comments may be submitted in the following ways:

  1. By email to: Policy.DHHS@maine.gov
  2. By mail to: Division of Policy/MaineCare Services, 242 State St. 11 State House Station, Augusta, Maine 04333-0011

Back to [Top]