• Read more about Section 67, Nursing Facility (NF) - Quality Bonus Pool (QBP) Payments

On December 22, 2025, we emailed QBP letters to administrators and senior level leadership for NFs that met the 2025 participation criteria to earn a QBP award. Each letter included the anticipated dollar amount for each NF, as described in MaineCare Benefits Manual (MBM), Chapter III, Section 67 (22.6.3). The payment date and confirmation of final amount is contingent on approval from the Centers for Medicare & Medicaid Services. We will send an update upon federal approval and will release payments approximately two weeks after federal approval.

• Read more about 2025 Health Care Reviews

Below are the Certificate of Need healthcare reviews conducted during the year of 2025. You can also view reviews from previous years.

Hospital/Acute Care Reviews

MaineHealth

Integration of York Hospital into MaineHealth

• Read more about MaineMOM

What is MaineMOM? 

MaineMOM is a MaineCare program providing team-based care for pregnant and postpartum individuals with Opioid Use Disorder (OUD^‡). Services are provided during pregnancy and through 12 months postpartum* and are designed to support recovery, promote healthy parenting, and improve maternal and infant health outcomes, as shown in the graphic to the right.  

• Read more about Revalidate with MaineCare to Avoid Claim Denials

Per the Affordable Care Act (ACA), Section 6401, all providers need to revalidate with all states they are enrolled with.

Durable Medical Equipment (DME) providers are required to revalidate their information with MaineCare every three years. The current round of revalidation began in January 2022.  

• Read more about Updated MaineCare Orthodontia Pro-Rate Request Form

Effective January 1, 2026, the MaineCare Orthodontia Pro-Rate Request Form is updated on the Manuals, Forms, and Criteria Sheets page of the Health PAS Online Portal.

This updated form reduces the administrative burden for providers and the Department when a prior authorization for Comprehensive or Limited Orthodontic treatment must be repriced because treatment stops before it is completed.

Jan 1, 2026

Tobacco use is the leading cause of preventable disease and death in Maine and the United States. It has major impacts on health care costs and lost productivity, affecting individuals, families, businesses, and the State.

• Read more about Quit Tobacco Services Preparing for January 5 Tobacco Tax Change

• Read more about CORRECTION to Section 65 Rates for January 1, 2026

MaineCare identified an error in the calculations for Section 65, cost-of-living adjustment (COLA) rates that were recently implemented with an effective date of January 1, 2026. The fee schedule also reflects this error.  

Jan 1, 2026

On January 1, 2025, Maine implemented a comprehensive reform of nursing facility reimbursement rates through MaineCare to stabilize a sector under strain, strengthen the direct care workforce, improve quality, and ensure continued access to care for Maine’s older adults.

One year in, the results are encouraging, and the State is moving forward with confidence into 2026.

• Read more about Nursing Facility Rate Reform: One Year In, and Building Toward 2026

• Read more about CORRECTION to Section 67, Nursing Facility (NF) Rate Letters Published on December 31, 2025

The Department identified an error in the capital cost calculations on the NF rate letters. Revised rate letters are now available on the secure Health PAS Online Portal.  

• Read more about Updated MaineCare Orthodontia Pro-Rate Request Form

Effective January 1, 2026, the MaineCare Orthodontia Pro-Rate Request Form is updated on the Manuals, Forms, and Criteria Sheets page of the Health PAS Online Portal.

This updated form reduces the administrative burden for providers and the Department when a prior authorization for Comprehensive or Limited Orthodontic treatment must be repriced because treatment stops before it is completed.