Nursing Facilities & Private Non-Medical Institutions Underpayments Identified through Audit

January 2, 2013

NURSING FACILITIES & PRIVATE NON-MEDICAL INSTITUTIONS UNDERPAYMENTS IDENTIFIED THROUGH AUDIT

Previously, for the purpose of identifying underpayments for auditing purposes, claims not billed to MaineCare were counted toward underpayment calculations. Effective January 1, 2013, MaineCare will no longer allow claims that are not billed to us to count toward an underpayment or overpayment calculation. Claims must be submitted and processed through MIHMS in order to be considered an overpayment or underpayment.