Attn: Nursing Facilities, COLA
June 8, 2012
The new Nursing Facility rates reflecting a 2% COLA have been implemented in MIHMS. There are three options for receiving the additional reimbursement for any claims you have submitted since October 1, 2011.
If your billed charges on your paid claims exceeded the MaineCare allowed amount plus the 2% increase, you may e-mail . Please provide Valoree your provider name and NPIs and we will arrange to have your paid claims adjusted.
If your billed charges on your paid claims equal the MaineCare allowed amount, you will need to rebill for any claims you have submitted since October 1, 2011. MaineCare cannot change the charges on a claim form.
You may choose to settle the rate change at the time of your cost settlement audit. Audit will utilize the corrected rates in their calculations of the allowable costs compared to the caps, which will result in you getting credit for the 2% increase.