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 a Children’s Health Insurance Program (CHIP) State Plan Amendment (SPA), effective January 1, 2024, to establish a health services initiative that will extend coverage of the CHIP Unborn Child Option (UCO) population to twelve months postpartum. The CHIP UCO population includes pregnant persons who are not eligible for MaineCare due to their immigration status. The postpartum services covered will be consistent with the comprehensive benefits package provided under regular MaineCare in terms of the amount, duration, and scope of services. This will directly benefit the health of eligible gestational parents and their infants.

REASON FOR PROPOSED CHANGES: Research shows that when gestational parents do not have access to care for mental health, substance use disorder, or other medical conditions, they have limited resources to fully respond to their child’s health needs. Untreated postpartum depression or substance use disorder can lead to child abuse and neglect, disruption in parental attachment, and adversely impact the child’s development. Children are less likely to access preventive care, attend well-child visits, and complete immunization schedules, and are more likely to experience avoidable hospitalizations when their parent does not have access to coverage.  

ESTIMATE OF ANY EXPECTED INCREASE OR DECREASE IN ANNUAL AGGREGATE EXPENDITURES: The Department anticipates that this change will result in an increase of $131,328 in federal fiscal year 2024 which includes $96,999 in federal funds and $34,329 in state funds, and will cost $175,104 in federal fiscal year 2025 which includes $129,244 in federal funds and $45,860 in state funds.

 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.


FOR RECEIPT OF COMMENTS:         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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