• Read more about Prohibited to Employ Individuals Excluded by Maine or Federal Government

MaineCare providers are prohibited from employing or contracting with people who have been excluded by the state or federal government.

Providers must screen all employees and contractors for exclusions and require their contractors to screen their staff for excluded individuals. Providers must screen all new potential employees prior to hire and should routinely screen all staff at set time intervals, e.g., annually, quarterly, etc.

• Read more about Novavax Monovalent COVID-19 Vaccine Authorized for Use as Booster Doses in Adults Ages 18 and Older

On October 21, 2022, the Office of MaineCare Services (OMS) sent an announcement that we will cover the Novavax monovalent COVID-19 vaccine booster doses as outlined in an Emergency Use Authorization (EUA) from the Food

• Read more about Billing Instruction Updates

Billing instructions are being updated to reflect the following changes: 

• Read more about Rate Determination Initiation Notice for Section 30 – Family Planning Services

This bulletin provides notice that the Department has initiated a Rate Determination Process* for Section 30 – Family Planning Services of the MaineCare Benefits Manual. The Department is conducting this rate determination. The newly determined rates will provide reimbursement under MaineCare that will better align with a team based, patient-centered approach to integrated care.  

• Read more about Electronic Visit Verification (EVV) Implementation Tips

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 is January 1, 2023.  

The following tips are designed to help providers’ EVV claims process in a timely manner. 

Three-Day Recycle Period 

Home Health and Hospice service claims with dates of service beginning on July 1, 2022, are subject to an EVV claim pend edit, unless a verified EVV record is found.

Nov 11, 2022

The Maine Department of Health and Human Services today published a comprehensive compilation of child care providers in the state that received nearly $74 million in COVID-19 Child Care Stabilization Grants, which helped Maine child care providers increase pay for staff and cover costs related to COVID-19.

• Read more about Maine DHHS Releases Recipients of Nearly $74 Million in Child Care Stabilization Grants

• Read more about Attention Providers of Section 65, Crisis Residential and Resolution Services: Draft Rate Model Public Review and Comment 

Earlier this fall MaineCare conducted a survey of Section 65 Crisis Residential and Resolution Services providers. We used the provider responses, in addition to other information, to create draft rate models for the services as part of the rate determination process. We outlined this process during our kick-off meeting with providers on May 12, 2022. This message outlines the next steps in the process related to draft rate models for the current Crisis Residential and Resolution services.

• Read more about Electronic Visit Verification (EVV) Implementation Tips

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 is January 1, 2023.  

The following tips are designed to help providers’ EVV claims process in a timely manner. 

• Read more about Temporary Occupancy Penalty Waiver for Nursing Facility Providers

The Office of MaineCare Services is temporarily waiving the minimum occupancy penalty for nursing facilities, found in Chapter III, Section 67, principle 18.9, through the end of the federal Public Health Emergency (PHE). The waiver applies to facilities with at least one month of service delivery under the PHE, starting with fiscal year ending June 30, 2020. 

• Read more about Electronic Visit Verification (EVV): Weekly Billers of Home Health and Hospice services and EVV Training and Forms

In preparation for EVV editing, providers must ensure billing software is configured to have individual dates of service on separate claim lines so they match up with a verified EVV record when claims are submitted as a batch file into the Health PAS Online Portal.