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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.
Effective May 10, 2025, we completed the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates in MIHMS. The following CMS documents provide the details of the APC and DRG updates:
May 5, 2025
The Maine Department of Health and Human Services (DHHS) is closely monitoring proposed federal budget reconciliation legislation that could profoundly impact the health and well-being of Maine residents. The proposals – currently under consideration by Congress – threaten to shift billions in costs to states, limit eligibility for critical programs, and erode the infrastructure that supports affordable health care and nutrition for hundreds of thousands of Mainers.
The Maine CDC marks Lyme Disease Awareness Month with Prevention Tips
AUGUSTA-- The Maine Center for Disease Control and Prevention (Maine CDC) urges Maine residents and visitors to take precautions to prevent tick bites. Governor Janet Mills proclaimed May Lyme Disease Awareness Month. This year's theme is "Don't Let a Tick Make You Sick."
In alignment with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate update, effective April 1, 2025, we retroactively updated the Physician Drug Rates. We implemented the new rates for billing on May 14, 2025.
New Codes
Beginning May 16, 2025, mental health and substance use agencies must use the following code modifier combinations to bill for medication management:
AUGUSTA-- The Maine Department of Health and Human Services (DHHS), through its Office for Family Independence (OFI), and Maine's Department of Education (DOE) have announced the return of the SUN Bucks and SUN Meals Programs for Summer 2025. Together, the SUN Programs help give children the nutrition they need in summer when school meals are unavailable.
May 5, 2025
Since 1995, the Maine CDC Breast and Cervical Health Program has helped clients access timely breast and cervical cancer screening, diagnostic, and treatment services. The program recently expanded eligibility to include qualifying women ages 21 and older -- lowering the previous age threshold of 35.
This change reduces the risk of undiagnosed cancers and the associated consequences of pain, illness, and premature death. It also addresses two critical public health considerations: