Mainecare Documentation Form


TO: Superintendents of Schools, Special Education Directors, CDS Regional Boards of Directors, CDS Regional Site Directors
FROM: Angela Faherty, Ph.D., Acting Commissioner
DATE: July 16, 2010
RE: Mainecare Documentation Form

The Departments of Education and Health and Human Services have been working collaboratively to develop refinements to Mainecare policies that will facilitate billing by school administrative units for medically necessary services. In addition, the Departments have reviewed the documentation requirements required by Mainecare in addition to the components of the Individualized Educational Program(IEP).

The Department of Health and Human Services has determined that a child’s individualized educational program (IEP) contains all but three pieces of documentation that are necessary for Mainecare billing. The three pieces of additional documentation that are needed are the signatures and the date of the plan, the plan of care, and a Crisis/Safety Plan. A Mainecare Documentation form that covers these three requirements can be found at . For each Mainecare eligible child for whom the school administrative unit will seek reimbursement for Mainecare services provided to that child, the Mainecare Documentation form must be completed before September 1, 2010 when the new Mainecare data system goes into effect. The Mainecare Documentation form should be filed with the child’s IEP.

If you have questions about this documentation process, please contact Jaci Holmes, Federal State Legislative Liaison, by phone at 624-6669 or by email at .

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