DHHS → node
On August 5, 2022, the Office of MaineCare Services (OMS) released a bulletin regarding planned MaineCare coverage of Monkeypox diagnostic testing and vaccines. This message is an update to that August 5th message.
The State of Maine has completed the process of a federally mandated Payment Error Rate Measurement (PERM) audit for Reporting Year 2021. (See e-message sent 02/06/2020.) This audit covered randomly selected paid claims with payments dated July 1, 2019, through June 30, 2020.
Claims Submission
On August 17, 2022, the Office of MaineCare Services (OMS) released a bulletin regarding the Emergency Use Authorization (EUA) for Novavax COVID-19 vaccine in individuals age 18 and older.
Effective August 20, 2022, we have updated MIHMS with the Centers for Medicare & Medicaid Services (CMS) quarterly updates. The following CMS documents provide the details of the updates:
July 2022 Integrated Outpatient Code Editor Specs: r11434cp.pdf (cms.gov)
Please review the reminder below pertaining to record retention requirements.
Are timesheets still required after implementation of the federal Electronic Visit Verification (EVV) requirement?
Aug 8, 2022
Today, the Maine Department of Health and Human Services (DHHS) posted a new “DHHS By the Numbers” Dashboard. It displays current data on services provided by the Department’s 3,400 workers in its eight Offices and two psychiatric hospitals. Examples include:
162,932 people were receiving help to purchase food through the Supplemental Nutrition Assistance Program as of May 1, 2022;
The Department is aware, through pharmacy dispensing data, that short-term claims for Letrozole have been prescribed for treatment of infertility. Letrozole is a preferred agent for the treatment of breast cancer.
Pursuant to Social Security Act, Section 1927 [42 U.S.C. 1396r–8] and MaineCare Benefits Manual Chapter II, Section 90, Physician Services, the off-label use of the preferred medication Letrozole, when it is used to promote fertility, is excluded from MaineCare coverage.
Effective October 31, 2022, UB-04 and 837I claims submitted without an attending provider will be denied.
The federal deadline to implement the EVV requirement for providers delivering Home Health services under Section 40 and Hospice Services under Section 43 is January 1, 2023.