Important Notice Regarding PCP Rate Increase Self Attestation Form

January 23, 2013

Important Notice Regarding PCP Rate Increase Self Attestation Form

If you faxed a form to MaineCare applying for an increased rate for your primary care services in calendar years 2013 and 2014, you may need to refax your Self Attestation form. Our fax machine was out of order from Wednesday, January 16th through Tuesday, January 22nd. If you faxed your form during this timeframe, MaineCare did not receive it and you should resend it as soon as possible. Our fax machine is now working.

Reminder: Qualifying physicians and advance practice clinicians must be providing services under the following pay-to/service location provider types: 35-Hospital/062-Hospital Based Professionals; 51-Physicians; or 54-Physician Group. A Self-Attestation form for the PCP increase and more information is available on the Provider Updates page of the MaineCare website.