• Read more about Attention Primary Care Plus (PCPlus) Providers: Reminder - PCPlus Open Office Hour

MaineCare’s Delivery System Reform Unit (DSRU) will be holding a PCPlus Open Office Hour on Tuesday, November 14, 2023, at 12PM. The purpose of the Open Office Hour is to provide an accessible online venue for PCPlus providers to come and ask MaineCare questions regarding the PCPlus model. During the Open Office Hour, we will also discuss the April 1, 2024 requirements for Tier 2 and Tier 3 PCPlus practices regarding hiring or contracting with community health workers and community-based organizations.

Nov 11, 2023

Today, the Maine Department of Health and Human Services (DHHS) released updated data on the resumption of MaineCare (Medicaid) eligibility reviews after the COVID-19 Public Health Emergency, known as “unwinding.”  This update is available on the MaineCare Renewals Data Dashboard and is based on more current data than reflected in previous months’ updates.

• Read more about Maine DHHS releases updated data on MaineCare eligibility reviews, including transitions to CoverME.gov

• Read more about MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 94, EPSDT

Notice of Agency Rule-making Proposal

• Read more about MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter II, Section 71, National Diabetes Prevention Program

Notice of Agency Rule-making Adoption

AGENCY: Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Chapter 101, MaineCare Benefits Manual (MBM), Chapter II, Section 71, National Diabetes Prevention Program

ADOPTED RULE NUMBER:

CONCISE SUMMARY:  

• Read more about Electronic Visit Verification (EVV) Phase 2 Trainings

The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.

We continue to offer weekly provider and aggregator trainings. All trainings are online via Microsoft Teams.

NOTE:  The Absorb training system has been updated to allow providers to register for trainings more than once.

EVV Training Schedule

• Read more about ​Reminder: State Funded Abortion

Effective September 19, 2019, MaineCare began covering abortion services that are not eligible for reimbursement from Centers of Medicare and Medicaid Services (CMS). It is important to submit claims with information that identifies the service because this service is only covered by State funds.   

• Read more about Post Exposure HIV Prophylaxis Hotline

The National Clinician Consultation Center offers free guidance on occupational and non-occupational exposure to HIV seven days a week. Call (888) 448-4911.  

• Read more about Certified Community Behavioral Health Clinics (CCBHC) Prospective Payment System (PPS) Cost Report Training: Presented Materials

On October 31, 2023, the Department with its vendor provided training to interested stakeholders on the CCBHC PPS cost report, via Zoom. The data submitted will support the ongoing development of this new service for which a rate determination process was initiated earlier this year.     

• Read more about Clubhouse Services Staff Requirements

Under Section 65.05-15.B(4), provider staff of mental health psychosocial clubhouse services must have completed an Association of Community Rehabilitation Educators (ACRE) approved certified employment specialist training, or equivalent. 

• Read more about Use of Nirsevimab and Palivizumab to Prevent Hospitalizations from Severe Respiratory Syncytial Virus (RSV) in High Risk Infants​

The Office of MaineCare Services (OMS) is currently accepting Prior Authorization (PA) requests for coverage of palivizumab due to the increasing trend of positive RSV tests. The clinical benefit of palivizumab therapy is best realized by timing the administration to coincide with the peak of RSV activity.