• Read more about Maine Comprehensive And Limited Environmental Laboratory Accreditation Rule - Adopted, effective 3-15-2023

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).

• 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.

NOTE:  The Absorb training system has been updated to allow providers to register for trainings and/or forums more than once.

• Read more about MaineCare Provider Directory API

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.

• Read more about Attention Providers of Section 17 Community Integration Services (CIS), Assertive Community Treatment (ACT) and Section 92 Adult Behavioral Health Homes (BHH) Hold for Service Requirements

We are notifying providers of CIS, ACT and Adult BHH services that they must enter their existing, internal waitlists into Kepro’s Atrezzo system no later than April 28, 2023. They must also remove any individuals on their waitlist who are no longer seeking services.

• Read more about CORRECTION: End of the 2022-2023 Seasonal Coverage for Use of Palivizumab Prophylaxis to Prevent Hospitalization from Severe Respiratory Syncytial Virus (RSV) Infection

We sent this message previously, omitting some text below. This is the corrected message.  

• Read more about Update to the ​Biosimilar Preferred Drug List

Effective April 3, 2023, the Department will add preferred and non-preferred drugs to the Biosimilar Preferred Drug List (PDL).    

The Department will add the following preferred drugs:   

• Read more about Fiscal Year 2023, Swing Bed and Days Awaiting Placement Rate Updates

Effective July 1, 2022, we have recalculated the per diem swing bed rate and nursing facility days awaiting placement rate for State Fiscal Year 2023.     

Critical access hospitals can bill the new swing bed rate of $317.44 per day for dates of services July 1, 2022, through June 30, 2023.     

• Read more about 2023 Indian Health Services (IHS) Rate Update, CR 118522

Effective January 1, 2023, the rate for IHS providers increased to $654.00. We will adjust claims billed between January 1, 2023, and March 7, 2023, and no provider action is needed.    

Please contact your Provider Relations Specialist with questions.    

• Read more about Facility License Renewal Reminder

MaineCare wants to remind providers to update their facility licenses prior to the expiration date to avoid possible claim denials or payment delays. To update your license, you need to login to the portal, go to the MaineCare Provider Enrollment Application (PEA), and perform a maintenance case.    

• Read more about Additional Drug Rate Updates, CR 106867

Due to the Centers for Medicare & Medicaid Services’ (CMS) rate update, we updated the rates for some drug codes retroactively to January 1, 2021, or July 1, 2021.   

See the table below for the effective dates and rates.