• Read more about Application Fee for 2025 Reminder, CR 128480

Effective January 1, 2025, in accordance with the Centers for Medicare & Medicaid Services (CMS) application fee requirements, MaineCare’s provider enrollment application fee will increase to $730 per enrollment application. This increase will apply to new, reactivating, or revalidating providers, or when adding new service locations to an existing enrollment. You can pay the application fee by credit or debit card at the time of application submission.     

• Read more about Updates to Service Provider Tax (SPT) Repeal Frequently Asked Questions (FAQ)

In response to MaineCare provider inquiries regarding SPT repeal, the Department updated the FAQs originally published and shared in the

• Read more about UPDATE: Notice of MaineCare 1115 Waiver Application: Substance Use Disorder Care Initiative Amendment

UPDATE: Notice of MaineCare 1115 Waiver Application: Substance Use Disorder Care Initiative Amendment

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

NATURE OF PROPOSED CHANGES: The state is requesting a budget neutrality projection adjustment for two components of the current 1115 Waiver Substance Use Disorder (SUD) Care Initiative.

• Read more about Training Opportunity Available for Family and Caregivers of Adults Receiving Services Within Section 12, 19, and 96 Programs

The Office of Aging and Disability Services (OADS), in collaboration with the National Alliance on Mental Illness (NAMI) Maine is excited to announce a virtual training De-Escalation opportunity scheduled for Tuesday, December 10, 2024, from 3:00 PM – 5:00 PM.

This training is available for caregivers providing care to Section 12, 19, and 96 members. Caregivers can include personal support staff, attendants, home health aides, nurses or other natural and family supports.

• Read more about Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840

This is a reminder that the attending provider is required on all UB-04 and 837I claims. MaineCare denies UB-04 and 837I claims submitted without an enrolled attending provider.

The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment reported in the claim/encounter. The attending provider requirement includes all claim submission methods (paper, HealthPAS Online Portal, or 837I).

• Read more about Taxonomy Code Requested on Claim Submissions – Portal Claims

The Office of MaineCare Services (OMS) is requesting that providers include the taxonomy code on all claims. The taxonomy code is necessary for the Centers for Medicaid and Medicare Services (CMS) to collect data for Transformed Medicaid Statistical Information System (T-MSIS) reporting. This data helps to inform states of their current standing in data quality as compared to other states and is crucial for research and policy on Medicaid and CHIP. The taxonomy is also used by  CMS to conduct program oversight, administration, and integrity.  

• Read more about Revalidate with MaineCare to Avoid Claim Denials

Per the Affordable Care Act (ACA), Section 6401, all providers need to revalidate with all states they are enrolled with.

Durable Medical Equipment (DME) providers are required to revalidate their information with MaineCare every three years. The current round of revalidation began in January 2022.  

• Read more about Rescheduled: Section 107, Psychiatric Residential Treatment Facilities (PRTFs): Revised Draft Rates Public Review and Comment Forum

The PRTF public review and comment forum has been rescheduled to December 17, 2024.  

MEETING DATE & TIME:  

Tuesday, December 17, 2024, 11:30AM – 1:00PM  

ZOOM Information: 

 https://mainestate.zoom.us/j/89397750850

Meeting ID: 893 9775 0850

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• Read more about MaineCare Cost-of-Living Adjustments and Service Provider Tax (SPT) Repeal Update

Cost-of-Living Adjustments (COLA) 

Due to current projected budget limitations, the Department will only be applying COLAs on January 1, 2025, that are required by federal law. Other COLA adjustments will be reliant on additional appropriations by the legislature. 

SPT 

• Read more about DHHS By the Numbers