Chapter 101, MaineCare Benefits Manual

Date posted:


Notice of MaineCare Reimbursement Methodology Change

AGENCY: Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual

NATURE OF PROPOSED CHANGES: The Department plans to submit future Medicaid and Children’s Health Insurance Program (CHIP) state plan amendments, effective October 1, 2023, to indicate that the Department covers, without cost sharing, all approved adult vaccines that are administrated in accordance with ACIP recommendations. The Department already covers all ACIP-recommended adult vaccines without cost sharing for Medicaid and CHIP beneficiaries.

REASON FOR PROPOSED CHANGES: Statutory amendments made by section 11405 of the Inflation Reduction Act mandate these state plan amendments. Coverage of all approved ACIP-recommended adult vaccinations, without cost sharing, improves access to vaccinations and has the potential to prevent hospitalizations and deaths and reduce costs associated with preventable infections.

ESTIMATE OF ANY EXPECTED INCREASE OR DECREASE IN ANNUAL AGGREGATE EXPENDITURES: The Department anticipates that this change will be cost neutral.

ACCESS TO PROPOSED CHANGES AND COMMENTS TO PROPOSED CHANGES: The public may review the proposed methodology changes and written comments at any Maine DHHS office in every Maine county. To find out where the Maine DHHS offices are located, call 1-800-452-1926. The Department will hold a hearing for the proposed rulemaking and will be publishing a notice which includes information on the hearing date and location.


                                                                         Henry Eckerson,

AGENCY NAME:                                            Office of MaineCare Services

ADDRESS:                                                       109 Capitol Street, 11 State House Station

                                                                          Augusta, Maine 04333-0011

TELEPHONE:                                                  (207) 624-4045 FAX: (207) 287-6106

                                                                         TTY: 711 Maine Relay

                                                                         (Deaf or Hard of Hearing)

See for rules and related rulemaking documents.

State Plan Amendment

Office: MaineCare Services


Comment deadline:

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