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As previously noticed, MaineCare is increasing certain hospital reimbursement rates to reflect a 1.0% COLA.
MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.
On December 29, 2025 the State of Maine received official notification (PDF) from the U.S. Centers for Medicare & Medicaid Services (CMS) of a $190 million award for Year 1 of the federal Rural Health Transformation Program.
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.
Notice of Agency Rulemaking Proposal
AGENCY: Department of Health and Human Services, Office of MaineCare Services, Division of Policy
CHAPTER NUMBER AND TITLE: 10-144 C.M.R, Chapter 101, Chapter III, Section 45, Principles of Reimbursement for Hospital Services
TYPE OF RULE: Routine Technical
PROPOSAL FILING NUMBER:
The Maine CDC urges protections against mosquito bites
AUGUSTA-- The Department of Health and Human Services' (DHHS) Maine Center for Disease Control and Prevention (Maine CDC) announced today the detection of a locally-acquired case of Eastern Equine Encephalitis virus (EEE) in a Maine resident. This is the first Maine resident to become infected with EEE this year.
This notice includes guidance from Acentra Health in partnership with the Office of MaineCare Services (OMS), on the use of shell cases in Atrezzo.
Paper RAs
This fall, the Office of MaineCare Services (OMS) will eliminate the mailing of all paper RAs to providers. This is a cost-saving initiative for the Department. We encourage those who receive paper RAs to reference the electronic PDF versions posted on the Health PAS Online Portal. Advantages of using the PDF version include easier member and claim searching and access to previous RAs.
Presenters needed for the Forum Dates & Locations:
MaineCare is once again inviting you to submit presentation proposals this year!
All MaineCare services delivered via Telehealth must comply with Ch I, Section 4 of the MaineCare Benefits Manual (MBM). Unless otherwise specified, all services must be billed in accordance with applicable sections of the MBM. Providers must also submit claims in accordance with Department billing instructions.