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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.
Providers who are enrolled with MaineCare may not request payment from MaineCare members for covered services.
Sep 9, 2025
Effective August 23, 2025, we completed the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates in MIHMS. The following CMS documents provide the details of the APC and DRG updates:
July 2025 Integrated Outpatient Code Editor Specs
July 2025 Update of Hospital Outpatient Prospective Payment System (OPPS)
On September 3, 2025, MaineCare held an online public meeting to present the recommended draft rates and rate models in addition to rationale for NF Specialty Units under Section 67 of the MaineCare Benefits Manual.
This emergency rulemaking operationalizes the statutory requirements of 34-B M.R.S. § 1203-B, Licenses for agencies that provide services to adults with certain conditions. Under this statute, any agency that provides a service, if that service is funded in whole or in part by the Department, to an adult with an intellectual disability, autism spectrum disorder, a related condition or an acquired brain injury, including a service provided under 22 M.R.S.
This routine technical rulemaking operationalizes the statutory requirements of 34-B MRS 1203-B, Licenses for agencies that provide services to adults with certain conditions. Under this rule, any agency that provides a service, if that service is funded in whole or in part by the Department, to an adult with an intellectual disability, autism spectrum disorder, a related condition or an acquired brain injury, including a service provided under 22 M.R.S.
Presenters needed for the Forum Dates & Locations:
MaineCare is once again inviting you to submit presentation proposals this year!