MaineCare 2024-25 Respiratory Syncytial Virus (RSV) Update
Peak RSV activity typically occurs between October and March. Please find information below regarding MaineCare’s coverage of nirsevimab (Beyfortus™) and palivizumab (Synagis®)
Nirsevimab
MaineCare 2024-25 Respiratory Syncytial Virus (RSV) Update
Peak RSV activity typically occurs between October and March. Please find information below regarding MaineCare’s coverage of nirsevimab (Beyfortus™) and palivizumab (Synagis®)
Nirsevimab
Facility Licenses Under Title 5
Providers whose facility license is under a Title 5 review may use their Title 5 notice to extend their enrollment with MaineCare in MIHMS by six months, and for every six months thereafter, until the Title 5 review is resolved. Providers must complete this update by submitting a maintenance case via the Health PAS Online Portal. Providers can utilize the Provider Maintenance User Guide for a step-by-step guide for submitting a Title 5 Maintenance Case.
Section 98, Therapeutic Foster Care (TFC), Final Draft Rates and Summary of Comments with Department Response
In June of 2023, the Office of MaineCare Services (OMS) initiated a rate determination process for Section 97, Appendix D, specific to TFC services.
Tips to Reduce Browntail Moth Hair Exposure During Fall Outdoor Activities
AUGUSTA – The Maine Center for Disease Control and Prevention (Maine CDC), the Maine Department of Agriculture, Conservation and Forestry’s Maine Forest Service (MFS), and 211 Maine remind residents and visitors to protect themselves from browntail moth hairs this fall.
10-144 CMR Ch. 265 Substance Use Testing in Workplace Rule
Maine’s Department of Health and Human Services has adopted amendments to 10-144 CMR Chapter 265, Substance Use Testing For The Workplace Rule.
10-144 C.M.R. Ch. 301; Supplemental Nutrition Assistance Program (SNAP) Rules; Section 777-4; SNAP Rule #235P - Procedures for Replacing Benefits Stolen Electronically
The Continuing Appropriations and Extensions Act, 2025, Public Law 118-83, Division B, Title I § 105, EBT Benefit Fraud Prevention Requirements will expire December 20, 2024. The Department proposes to update Section 777-4 of the Supplemental Nutrition Assistance Program (SNAP) Rules consistent with the end of the federal authorization for replacement of EBT benefits stolen through card skimming, card cloning, or similar fraudulent methods.
MC Rule #309A - 10-144 C.M.R. Ch. 333; Low Cost Drugs for the Elderly and Disabled (DEL) Eligibility Manual;
MaineCare Rule #309A - DEL Updates
The adopted rule updated Section 2, APPLICATION PROCESS, consistent with a legislative change to 22 M.R.S. § 3174-LLL made by P.L. 2023, ch. 412. Effective retroactive to July 1, 2024, individuals who are enrolled in Medicaid and/or Medicare Buy-In (MSP), who are eligible for Medicare Part D, and meet the income criteria in Section 2.2, are deemed to be eligible for and enrolled in DEL. These individuals do not need to file a separate application.
In addition, the adopted rule effectuates the following changes:
10-144 C.M.R. Ch. 331; Public Assistance Manual Temporary Assistance For Needy Families (TANF) Program; TANF Rule #120A - Step Disregard
The adopted rule effectuates changes to Chapter IV of the Public Assistance Manual Temporary Assistance for Needy Families (TANF) consistent with a legislative change to 22 M.R.S. § 3762 made by P.L. 2023, Ch. 29, An Act to Improve Family Economic Security Under the Temporary Assistance for Needy Families Program.
The adopted rule updated Chapter IV, B, INCOME DISREGARDS as follows:
Attention Providers Interested in the Certified Community Behavioral Health Clinic (CCBHC) Medicaid Demonstration
Earlier this fall, MaineCare with its vendor Mercer, conducted a review of provisionally certified provider cost reports for the CCBHC Medicaid Demonstration. We used provider responses, in addition to other information, to create draft rate models for the services as part of the rate determination process*. We outlined this process during our kick-off meeting with providers on September 25, 2023.