Attention Providers of Sections 17, 28, and 65: Behavioral Health Rate FAQs
As mentioned in the notice on February 2, 2023, the Department now has available the Behavioral Health Rate FAQ document on billing and authorizations for serv
Attention Providers of Section 31 Federally Qualified Health Centers (FQHC): Rebasing Stakeholder Informational Session: Presented Materials
As previously shared in our September 27, 2022 bulletin, the Department initiated a rate determination process for Section 31, Federally Qualified Health Centers, (FQHCs).
Limited Availability of MaineCare Preferred Albuterol Products
Effective January 20, 2023, MaineCare added additional albuterol products with preferred status to our Preferred Drug List (PDL). These preferred products do not require prior authorization (PA):
XDEA License Requirement for Buprenorphine Claims Removed
On December 29, 2022, Congress eliminated the “DATA-Waiver Program” with the signing of the Consolidated Appropriations Act of 2023 (the Act), improving access to buprenorphine for those in need.
XDEA License Requirement for Buprenorphine Claims Removed
On December 29, 2022, Congress eliminated the “DATA-Waiver Program” with the signing of the Consolidated Appropriations Act of 2023 (the Act), improving access to buprenorphine for those in need.
XDEA License Requirement for Buprenorphine Claims Removed
On December 29, 2022, Congress eliminated the “DATA-Waiver Program” with the signing of the Consolidated Appropriations Act of 2023 (the Act), improving access to buprenorphine for those in need.
XDEA License Requirement for Buprenorphine Claims Removed
On December 29, 2022, Congress eliminated the “DATA-Waiver Program” with the signing of the Consolidated Appropriations Act of 2023 (the Act), improving access to buprenorphine for those in need.
Attention Behavioral Health and Targeted Case Management Providers - Behavioral Health and Targeted Case Management Supplemental Payment Information
As a follow-up to our June 21, 2022 e-message regarding Behavioral Health and Targeted Case Management supplemental payments for providers of:
Implementation of January 1, 2023 Rate Study Increases for Sections 28 and 65
As of yesterday, February 1, 2023, updated rates, modifiers and/or units for Sections 28 and 65 are now available for billing in MIHMS. These changes will be effective retroactive to January 1, 2023, and result from our recent rate studies conducted in relation to P.L. 2021 Ch. 398, Pt. AAAA; Ch. 635, Pt JJJ; and Ch. 639. New rates will apply only to services provided on or after January 1, 2023.
Attention Nursing Facilities and Residential Care Facilities (PNMI, Appendix C) – Rates Effective January 1, 2023
MaineCare has adjusted reimbursement rates retroactive to January 1, 2023 for Nursing Facilities and Residential Care Facilities (PNMI, Appendix C) in accordance with P.L. 2021 Ch. 398, Part AAAA in order to continue to enable providers to cover labor costs for essential support workers to at least 125% of the minimum wage.