Re-Entry Update #2
May 11, 2022
Good Afternoon,
Work continues on preparing to implement our permanent telework policy starting September 6.
Re-Entry Update #1
April 27, 2022
Good Afternoon,
The Maine Department of Health and Human Services (Department) has begun both ending its pandemic footing and preparing for a permanent telework policy effective September 6, 2022. We are calling the transition from April 25 to September 6 a “return to offices” or “re-entry” for short.
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 45, Hospital Services and Chapter III, Section 45, Principles of Reimbursement for Hospital Services
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the p
Health PAS Online Portal Issues Resolved
We have resolved the timing out and extended wait time issues that providers reported experiencing on the Health PAS Online Portal.
We apologize for any inconvenience these issues may have caused you.
Change of Edit 6075 from Deny to Warn, CR 109501
We have identified a defect in Edit 6075 logic which is causing some claims submitted by Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), Indian Health Services (IHS) providers, and School Health Center providers with paid encounter services to incorrectly deny the T1015 service. We will notify you when this issue is corrected and affected claims will be reprocessed. No provider action is needed.
Please contact your Provider Relations Specialist, Tia Bolduc, with any questions.
Attention Providers of Adult Behavioral Health Services: Updated Critical Incidents Definitions
The Office of Behavioral Health (OBH), in coordination with Kepro, have updated the definitions of a Critical Incident to better clarify when it must to be reported through the Kepro Atrezzo system.
COVID-19 Vaccines, Pre-Exposure Prophylaxis, and Treatment for Non-Hospitalized Patients
COVID-19 vaccination remains the best way to prevent infection, hospitalization, and death. COVID-19 vaccination is recommended for individuals five years and older; a booster dose is recommended for individuals 12 years and older, and a second booster is authorized for individuals 50 years and older.
Patients who are moderately or severely immunocompromised should receive additional vaccine doses and may also receive pre-exposure prophylaxis to further reduce the risk of infection, hospitalization, and death.
Psychiatric Residential Treatment Facility (PRTF) Information Request
The Office of Child and Family Services (OCFS), in partnership with the Office of MaineCare Services (OMS), developed a MaineCare policy for Children’s Psychiatric Residential Treatment Facility (PRTF) services under the MaineCare Benefits Manual, Section 107, in 2018.
Health PAS Online Portal Intermittent Issues
We understand you may be experiencing issues with the Health PAS Online Portal. You may have extended wait times, timing out of applications, and no response when attempting to view and submit prior authorizations, adjusting claims, or accessing certification submissions.
We are working to correct the issues as soon as possible and will send another message when they are resolved.
Please contact Provider Services with questions by email or call 1-866-690-5585.
Notice of Agency Rule-making Adoption: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the propo