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MaineCare has identified some pharmacy claim lines that denied in error for JCode/NDC missing or invalid due to a delay in the January 1, 2023, quarterly update from the Centers for Medicare & Medicaid Services (CMS). The Claims Adjustment Reason Code (CARC) and Remittance Advice Remark Code (RARC) are as follows.
Effective March 7, 2023, MaineCare increased the rate for IHS providers to $654.00 retroactively to January 1, 2023. We will adjust claims billed between January 1, 2023, and March 7, 2023, and you do not need to take action.
Please contact your Provider Relations Specialist with questions.
MaineCare identified a claims issue where vision service codes 92250 and 92341 processed with MaineCare as the primary payor even though the member had an active primary vision insurance carrier that the provider did not bill first.
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.
As of March 15, 2023, MaineCare temporarily excluded Hospice services from EVV requirements retroactive to January 1, 2023, as a delayed enforcement of our approved State Plan requirements. This temporary exclusion will continue until the Department can adopt final rules for Section 43, Hospice Services, which we currently anticipate will happen in the second half of 2023. This change affects hospice providers who bill codes T2042, G0299, G0155, and T2043.
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 substance use and mental health treatment. The goal is to publicly launch this tool in spring 2023.
There is NO COST to your agency to participate in this initiative. To learn more about this and how to onboard to the platform, we encourage you to attend an orientation event listed below.
The DHHS Financial Service Center is a Division of DAFS (Department of Administrative and Financial Services). This Service Center consists of a consolidation of functions which include Grant Accounting, Budgeting, Forecasting, Accounts Payable, Accounts Receivable, Cost Allocation, Collections, Hospital Billing, and Business Intelligence. Our sole client is the Department of Health and Human Services.
Sarah Gove | Director
Sarah.Gove@maine.gov
(207) 458-6626
The Department of Health and Human Services - Maine Center for Disease Control and Prevention (DHHS) adopted routine technical rule changes jointly with the Department of Environmental Protection (DEP) to amend the Maine Comprehensive and Limited Environmental Laboratory Accreditation Rule by establishing a revised fee schedule based on the cost of certifying or accrediting laboratories, pursuant to 22 MRS §567(4).
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.
Consistent with Federal requirements, the MaineCare Provider Directory API conforms to the technical standards for data exchange via a secure API and meets the specifications outlined in the PDEX Payer Network Implementation Guide.