• Read more about 10-144 C.M.R. Chapter 332; MaineCare Eligibility Manual, Chart 4.3, Rule #302 - Penalty Divisor Rule

This proposed rule updates the average nursing care private rate, listed in Chart 4.3 of the MaineCare Eligibility Manual, to the most current figure available from the Department's internal audit team. Effective June 1, 2023, the average nursing care private rate is determined from rates reported by nursing facilities on the MaineCare Cost Report. The rule also adds a description of how the rate is used to calculate penalty periods for disposing of assets for less than fair market value on or after the look-back period.

• Read more about Attention Providers of Section 31, Federally Qualified Health Centers (FQHC): Draft Rate Methodology Public Review Presented Materials and Comments  

On March 30, 2023, MaineCare held an online public meeting to present a draft Alternative Payment Methodology (APM) along with the rationale for the recommended methodology for section 31, Federally Qualified Health Centers.

• Read more about Attention Providers of Section 18, 19, 20, 21, and 29 Services: Appendix K to Maine’s Home and Community Based Services (HCBS) Waivers Continues to Provide Temporary Flexibilities on Service Caps and Staffing

Appendix K to Maine’s HCBS 1915(c) waivers provides the state certain flexibilities in waiver program operations during an emergency. Maine’s Appendix K and amendments may be found on Medicaid.gov.

• Read more about Attention Section 97, Appendix B Residential Substance Use Providers: Webinar Offering 

DHHS is hosting a webinar to orient prospective or new Section 97, Appendix B Residential Substance Use Disorder (SUD) providers to DHHS. The webinar will include the following topics:   

• Read more about Attention Providers of Sections 17, 28, and 65: Behavioral Health Rate FAQs Update 

As a follow up to the notice on February 2, 2023, the Department has updated the Behavioral Health Rate FAQ document on billing and authorizations for

• Read more about 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. 

• Read more about Rounding Rule Information for Providers of Section 25, Dental Services

On May 29, 2022, MaineCare adopted changes to the rounding rule in Chapter I, Section 1.03-8(J), effective January 1, 2023, which the Department will not enforce until May 1, 2023. MaineCare provided a future effective date and delayed enforcement of the rule to give providers time to make necessary system changes to bill for partial units of service.

• Read more about Update to the Rounding Rule Enforcement Date

This notice is an update to the e-message sent on January 20, 2023. MaineCare is extending its delay of the enforcement of the rounding rule by one month, from April 1, 2023, to May 1, 2023, to allow further time for necessary system changes.

• Read more about Correction: Section 26 Day Health Services: Rate Study Comment Summary

We previously sent this notice on March 30, 2023, with an incorrect link to the summary of comments. We corrected the link below.  

Mar 3, 2023

Since the start of the Mills Administration, the Department of Health and Human Services (DHHS) has prioritized both expanding eligibility for MaineCare and improving how the program pays for services for its members. These efforts have culminated in significant achievements that the Department continues to build on to further promote quality, accessible services for the over 400,000 Maine residents currently served by the program.

• Read more about DHHS Achieves Progress on MaineCare Rate Reform