Specifications include, but are not limited to: Facility Requirements The awarded Bidder(s) and any proposed subcontractor(s) must have and maintain a valid Maine license to operate a mental health agency according to the requirements of 14-193 C.M.R. C h. 6 during the entire contract period. Maintain enrollment as a MaineCare Provider. Maintain an administrative office in the respective Region of the State ensuring Veterans have access to services throughout the Region. Operate during regular business hours of Monday through Friday, 8 a.m. to 5 p.m., except during State holidays and administrative closings. Eligibility Determination Requirements Ensure Veterans are deemed eligible if they: Received a mental health diagnosis and/or mental health disability rating from the United States Department of Veteran Affairs (U.S. VA); and/or Are not enrolled with the U.S. VA but have been determined to require mental health care services by a licensed mental health professional. Are eligible for MaineCare even though they may not meet requirements for Eligibility for Care and Community Support Services as outlined in the MBM 10-144 C.M.R. Ch 101, Ch II § 17.0 2 1. Ensure each Veteran provides a copy of their Certificate of Release or Discharge from Active Duty ( DD Form 214 ) and Incomplete Awards, Decorations, and Discharges (DD Form 215 ), or Report of Separation and Military Service ( NGB Form 22/22A ). Document the Veteran’s eligibility and Registration in the Department’s designated system. Veteran Health Insurance Coverage Screening and Billing Methods Determine if eligible Veterans have either private health insurance or are MaineCare Members prior to providing CI Services. Assist Veterans without MaineCare or private insurance in applying for MaineCare benefits within thirty (30) calendar days of the date services are initiated and annually thereafter. If the pre-screening indicates that the Veteran is potentially eligible for MaineCare, provide the Veteran with assistance in completing the full MaineCare application (refer to My Maine Connection). Submit claims to MaineCare for Veterans who are MaineCare Members, ensuring: Claims are limited to the standard terms of MaineCare/Medicare reimbursement; Medically Needy Deductibles are met by the Member (if financially able), before submitting a claim to MaineCare.
