Children’s Behavioral Health & Residential Treatment

Applying for Children’s Residential Care Facility Services

OCFS contracts with KEPRO to manage Children’s Residential Care Facility Services (CRCF). Children’s Residential Care Facility Services for children follows the MaineCare Section 97 eligibility criteria. KEPRO processes all applications and completes Prior Authorizations for Children’s Residential Care Facility Services, and they are your contact related to approval for admissions to Children’s Residential Care Facility.

Rule Adoption: Amyotrophic Lateral Sclerosis Incidence Registry Rule; 10-144 CMR Chapter 175

The adoption of Maine’s Amyotrophic Lateral Sclerosis Incidence Registry Rule, a new rule administered by the Maine Center for Disease Control and Prevention, establishes data collection requirements and data release protocols specific to reportable cases of patients diagnosed with amyotrophic lateral sclerosis (ALS). For the purpose of the statewide ALS registry required by 22 MRS Sec.

Provider Responsibility for Managing Users in My HealthPAS Trading Partner Accounts (TPA)

It is important for your TPA administrator to actively manage your user accounts for the Health PAS Online Portal. To manage users, log into the administrator TPA and click on “Account Maintenance” and then “Manage Users”. Edit existing, deactivated or reactivated users by clicking on the row of the user you would like to manage. The Administrator of the account and users with a security role of “R7-User Management” are allowed to use these features. 

Pharmacy Copayments Return with the End of the American Rescue Plan (ARP) Act on September 30, 2024

In accordance with federal requirements set forth in ARP, MaineCare covers COVID-19 testing, treatment, vaccine, and vaccine administration without cost sharing, for all MaineCare members through September 30, 2024. To comply with this requirement, MaineCare waived copayments for Section 80: Pharmacy Services. 

Effective October 1, 2024: 

Important COVID-19 Vaccine Coverage Information: End of Coverage for Limited Family Planning Benefit

Effective October 1, 2024, MaineCare will discontinue coverage and reimbursement for COVID-19 vaccines and vaccine administration for members covered under the Limited Family Planning benefit.  

At the beginning of the COVID-19 pandemic, the federal government declared a Public Health Emergency (PHE) and expanded coverage for certain limited benefit groups to ensure Medicaid members could access COVID-19 related healthcare services.  

Attention HCBS Providers of Clinical Therapy Services for Sections 19, 20, 21, 40, & 102: Interested Parties Engagement Session Presented Materials

As previously noticed in our Kickoff meeting Presented Materials notice, MaineCare with its vendor is holding several engagement sessions with interested parties to discuss and accept feedback that will inform the draft rates for certain HCBS services in Sections 12, 18, 19, 20, 21, 29, 40, 96, and 102.   

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