The Restriction Plan is an administrative procedure where certain MaineCare members who have a history of over-utilizing MaineCare benefits must receive their primary medical care from one health care provider, and when indicated, one hospital, one pharmacy and specified additional providers, (such as a behavioral health provider, dentist, eye care provider). The Department of Health and Human Services anticipates that restricting members who over-utilize services to a single primary care provider will result in better health care management and the reduction of the total cost of care.
C.M.R. 10, 144, ch. 101, ch. VI, 144-101-VI-01, subsec. 144-101-VI-01.01