Attention Section 45 Hospitals, Distinct Psychiatric and Substance Use Disorder (SUD) Units: Rate Determination Update
Last Fall, MaineCare initiated a rate determination for Section 45, Distinct Psychiatric and SUD units.
Attention Providers of Section 107, Psychiatric Residential Treatment Facilities (PRTFs) – Presented Materials and Comment Period
On June 15, 2023, MaineCare held an online public meeting to present draft rate models along with rationale for the recommended rate models for Section 107, PRTFs.
Service Locator Tool – Invitation to Behavioral Health Providers
The Department of Health and Human Services (DHHS) is excited to announce the creation of a Service Locator Tool hosted on Bamboo Health’s TreatmentConnection.com. The Tool will improve access to treatment for substance use and mental health issues. The goal is to publicly launch this tool in summer 2023.
Extended Release Buprenorphine (XRB) Clinical Use Criteria
In order to promote access to Sublocade, XRB, MaineCare may engage in rulemaking. In the meantime, providers may bill the medical benefit for XRB without prior authorization if their documentation meets the criteria outlined below. The criteria will be available on the Preferred Drug List after the July 2023 update. Failure to meet these criteria could result in sanctions.
MaineCare Extended-Release Buprenorphine Clinical Criteria
Bonuses Help Stabilize and Grow Maine’s Home and Community Based Service Workforce
Jun 6, 2023
New data indicate that a Department of Health and Human Services (DHHS) initiative to fund recruitment and retention bonuses for direct support workers (DSWs) helped stabilize and grow Maine’s Home and Community Based Services (HCBS) workforce.
HCBS DSWs assist Maine people of all ages with physical disabilities, intellectual and developmental disabilities, and mental or behavioral health conditions. Their work is central to keeping people in their homes and communities while providing accessible, high-quality services to help them stay healthy and fulfil their personal goals.
Guidance for Psychiatric Hospitals Seeking Prior Authorization (PA) for Mental Health Intensive Outpatient Services
Psychiatric Hospital providers seeking to bill for Mental Health Intensive Outpatient (MH-IOP) Services under MaineCare Benefits Manual (MBM) Ch. II, Section 46.05-3 will be asked to submit PA requests through Atrezzo. Acentra Health (formerly Kepro) will review these requests in accordance with the substantive standards for MH-IOP services adopted in the November 9, 2022, revision of MBM Ch. II, Section 65 (Behavioral Health Services).
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter I, Section 4, Telehealth Services
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the
Electronic Visit Verification (EVV) Trainings and Forums
The federal deadline to implement the EVV requirements for Home Health providers delivering services under Section 40 and Hospice providers delivering services under Section 43 happened January 1, 2023.
We continue to offer weekly provider and aggregator trainings and forums. All trainings and forums are online via Microsoft Teams.
NOTE: The Absorb training system has been updated to allow providers to register for trainings and/or forums more than once.
Community Partnerships and Financing Strategies to Address Health-Related Social Needs
HRSN Webinar Series
NEW ENGLAND RURAL HEALTH ASSOCIATION
WEBINAR SERIES
Thank you to the Maine Health Access Foundation for their support on this webinar series!