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We implemented new rates for Sections 68, 85 and 109 retroactively to January 1, 2025.
You may view the updated fee schedules on the rate setting page of the Health PAS Online Portal.
Adjusting Claims
On March 14, 2025, we held the Annual Draft Rate Determination Schedule Consultation with the TAP which was open to the public.
The Division of Licensing & Certification (DLC) provides regulatory oversight of medical and long-term care facilities in Maine. This includes oversight of the CNA registry, criminal background checks for employers to ensure staff are safe to care for our vulnerable citizens, and investigations into allegations of unsafe practices/events in facilities as diverse as hospitals, nursing homes, assisted living facilities, and group homes.
10-144 C.M.R. Chapter 332; MaineCare Eligibility Manual – Part 9: LIMITED BENEFIT GROUPS and Chart 3.8: Premiums for Special Benefits Waiver [Maine Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS]
MaineCare Rule #312P – Part 9 and Chart 3.8 Premium Updates
10-144 C.M.R. Chapter 331; Public Assistance Manual Temporary Assistance for Needy Families (TANF) Manual, Chapter II
TANF Rule #124 – COFA Update
PRINCIPAL REASON(S) OR PURPOSE FOR PROPOSING THIS RULE:
Maine's Department of Health and Human Services Maine Center for Disease Control and Prevention is proposing this rule to coincide with the expiration of the rule adopted on an emergency basis (effective January 31, 2025), ensuring the additional $5.00 for burial-transit permits issued in Maine remains in rule as required by Public Law 2023, Chapter 677, 4.
The Department is proposing these changes to amend Chapter 1 and hold public comment, so that adoption of this non-emergency rule may coincide with the expiration of the emergency rule, which became effective January 31, 2025.
On February 26, 2025, we announced that, absent emergency action by the Legislature, the Department would need to temporarily hold certain provider payments beginning with the payment cycle that will run on March 12, 2025. As of the time of this message, the Legislature has not approved the necessary funding to avoid these measures.
On February 26, 2025, we announced that, absent emergency action by the Legislature, the Department would need to temporarily hold certain provider payments beginning with the payment cycle that will run on March 12, 2025. As of the time of this message, the Legislature has not approved the necessary funding to avoid these measures.
With the end of the COVID-19 public health emergency and Appendix K flexibilities, Section 21 Home Support- Agency Per Diem providers must follow service requirements outlined in the MaineCare Benefits Manual (MBM) regarding the number of members served. MBM Ch. II, Section 21.10-6 states "As of December 24, 2012, Home Support- Agency Per Diem placements will only be approved at provider-controlled homes where a minimum of two (2) Members reside.”