• Read more about Maine CDC and DOE Release 2025 Student Health Survey Results

Data show encouraging progress in mental health and reduced substance use among Maine students

AUGUSTA-- The Maine Department of Health and Human Services' (DHHS) Maine Center for Disease Control and Prevention (Maine CDC) and the Maine Department of Education (Maine DOE) announced today the release of the 2025 Maine Integrated Youth Health Survey (MIYHS) data, showing positive trends in mental health and reduced substance use among Maine students.

• Read more about Health PAS Online Portal Down Time Update - November 2025

This is an update to the notice we sent on July 24, 2025, about Health PAS Online Portal downtimes.

The portal will continue to remain down Monday through Friday from 7:00 PM to 7:00 AM and all weekend hours as Gainwell continues to address technical issues.

The portal will remain available from 7:00 AM to 7:00 PM Monday through Friday except for holidays, when state offices are closed.

• Read more about MaineCare Benefits Manual, Chapter III, Section 45,Principles of Reimbursement for Hospital Services

Notice of Agency Rule-making Adoption

AGENCY: Department of Health and Human Services, Office of MaineCare Services

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 45, Principles of Reimbursement for Hospital Services

ADOPTED RULE NUMBER:

CONCISE SUMMARY:

• Read more about MaineCare Notice of Agency Rule-making Adoption, Chapter III, Section 45, Principles of Reimbursement for Hospital Services

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the 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 Secretary of State’s website.

• Read more about Taxonomy Code Requested on Claim Submissions – Portal Claims

The Office of MaineCare Services (OMS) is requesting that providers include the taxonomy code on all claims. The taxonomy code is necessary for the Centers for Medicaid and Medicare Services (CMS) to collect data for Transformed Medicaid Statistical Information System (T-MSIS) reporting. This data helps to inform states of their current standing in data quality as compared to other states and is crucial for research and policy on Medicaid and CHIP. The taxonomy is also used by CMS to conduct program oversight, administration, and integrity.  

• Read more about Provider Responsibility for Managing Users in my Health PAS Trading Partner Accounts (TPA)

It is important for your TPA administrator to actively manage your user accounts for the Health PAS Online Portal. To manage users, log into the administrator TPA and click on “Account Maintenance” and then “Manage Users.” Edit existing, deactivated or reactivated users by clicking on the row of the user you would like to manage. The Administrator of the account and users with a security role of “R7-User Management” are allowed to use these features. 

• Read more about Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840

This is a reminder that the attending provider is required on all UB-04 and 837I claims. MaineCare denies UB-04 and 837I claims submitted without an enrolled attending provider.

The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment reported in the claim/encounter. The attending provider requirement includes all claim submission methods (paper, HealthPAS Online Portal, or 837I).

• Read more about CORRECTION: Biosimilar Preferred Drug List (PDL) 2026 Update

Effective January 1, 2026, the Department will add preferred and non-preferred drugs to the Biosimilar PDL.

Preferred drugs added:

• Q 9996 Ustekinumab-ttwe SubQ
• Q 9997 Ustekinumab-ttwe I.V.
• Q5140 - adalimumab-fkjp
• Q5141 - YUFLYMA, adalimumab-aaty
• Q5142 - SIMLANDI, adalimumad-ryvk 
• Q5143 - CYTEZLO, adalimumab-adbm
• Q5144 - IDACIO, adalimumab-aacf
• Q5145 - ABRILADA, adalimumab-afzb

Change from preferred to non-preferred drug:

• Read more about Maine CDC Alerts Consumers About Recall of ByHeart Whole Nutrition Infant Formula Due to Botulism Risk

Maine parents and caregivers advised not to buy or use ByHeart Whole Nutrition infant formula while the U.S. FDA investigation is ongoing

• Read more about Biosimilar Preferred Drug List (PDL) 2026 Update

Effective January 1, 2026, the Department will add preferred and non-preferred drugs to the Biosimilar PDL.

Preferred drugs added:

• Q 9996 Ustekinumab-ttwe SubQ
• Q 99976 Ustekinumab-ttwe I.V.
• Q5140 - adalimumab-fkjp
• Q5142 -SIMLANDI, adalimumad ryvk

Change from preferred to non-preferred drug: