• Read more about Prescribing Providers Must Enroll in MaineCare

Beginning September 1, 2025, MaineCare will only pay for prescriptions that are from providers who are enrolled with MaineCare.   

Full or Non-Ordering, Prescribing and Referring Provider (NOPR) Enrollment options are available. 

May 5, 2025

Portland recently became a hub of transformative dialogue and collaboration as over 500 stakeholders convened for the 2025 Innovation Summit: A Path for Maine. Hosted by DHHS' Office of Aging and Disability Services (OADS), and in partnership with the National Disability Institute, the Summit united providers, policymakers, advocates, and innovators dedicated to enhancing the lives of individuals with intellectual and developmental disabilities (IDD), autism, brain injuries, and other related conditions.

• Read more about Innovation and Inclusion: Advancing a Path for Maine

• Read more about Clarifications to Section 65 Medication Management Code Changes

This notice clarifies changes described in the Section 65 Medication Management Code Changes notice sent on May 16, 2025.

• 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 Microdyn Update for Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) - CRs 131553, 131554, & 131582

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:   

• Read more about Drinking Water Rule, 10-144 CMR Ch. 231

This Rule administers the State of Maine drinking water requirements for approximately 1,900 public water systems by the Department’s Maine CDC Drinking Water Program (Department), which has federal primacy.

May 5, 2025

Editor's Note: This blog was originally published on May 20 and was since updated on May 28 to reflect developments as of May 22, when the U.S. House of Representatives passed the FFY 2025 budget reconciliation bill, formally titled the One Big Beautiful Bill Act. The updated content below incorporates policy changes included in the final House-passed version.

• Read more about Federal Proposals Threaten Health Coverage, Nutrition Assistance, and Marketplace Stability in Maine

• Read more about "Don't Let a Tick Make You Sick"

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."

• Read more about Quarterly Physician Drug Code and Rate Update: QTR 2, CR 131894

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. 

• Read more about Section 65 Medication Management Code Changes

New Codes

Beginning May 16, 2025, mental health and substance use agencies must use the following code modifier combinations to bill for medication management: