information regarding Maine program Short-term: Changes to Optional Benefits Self-Directed personal assistance services – what might the consultants recommend Inpatient psychiatric services for individuals under 21 – require periodic re-authorization Out-of-state services – provide any information on Medicaid services Maine pays for any out-of-state services. Rehab Services (BH $ Substance Abuse) – Med Management, further define “up to 1 hr.” Is it annual? Weekly? More detail needed on Maine trends versus other states Dental – research studies regarding cost avoidance and provide list of states that contract services out Chiropractic – further limiting or elimination Presentation by Seema Verma Private duty nursing – budget number by age group and Rob Damler cont. Personal care – budget numbers Case Management – provide list of groups eliminated Services for Individuals Age 65 or Older in an Institution for Mental Disease (IMD) Mid-Term Strategy: Eligibility Changes Review spend down eligibility and current medical expenses considered for eligibility. Increased use of generics – need to explore Rebates - cross over pharmacy claims and specialty pharmacy costs in Maine compared to other states HIT – explore restricted card program Mid-Term Strategy: Program Integrity
Presentation by Seema Verma and Rob Damler cont. information regarding Maine program Short-term: Changes to Optional Benefits Self-Directed personal assistance services – what might the consultants recommend Inpatient psychiatric services for individuals under 21 – require periodic re-authorization Out-of-state services – provide any information on Medicaid services Maine pays for any out-of-state services. Rehab Services (BH $ Substance Abuse) – Med Management, further define “up to 1 hr.” Is it annual? Weekly? More detail needed on Maine trends versus other states Dental – research studies regarding cost avoidance and provide list of states that contract services out Chiropractic – further limiting or elimination Private duty nursing – budget number by age group Personal care – budget numbers Case Management – provide list of groups eliminated Services for Individuals Age 65 or Older in an Institution for Mental Disease (IMD) Mid-Term Strategy: Eligibility Changes Review spend down eligibility and current medical expenses considered for eligibility. Increased use of generics – need to explore Rebates - cross over pharmacy claims and specialty pharmacy costs in Maine compared to other states HIT – explore restricted card program Mid-Term Strategy: Program Integrity