Therapeutic Foster Care (TFC) Duplicative of Other MaineCare Services

MaineCare Benefits Manual (MBM) Chapter II, Section 97, TFC includes case management which is duplicative of other MaineCare covered case management services. This includes targeted case management delivered by Certified Community Behavioral Health Centers and all services covered under Sections 13, 89, 91, 92, and 93.

As a result, providers may not seek reimbursement for any of the above-mentioned services if the member receives TFC.

For questions, please contact Bruce Cosgrove, Provider Relations Specialist.

 

Section 67, Nursing Facilities Public Forum: Updates to Value-Based Purchasing (VBP) in 2026 and 2027

On October 15, 2025, the Department will host a public forum to provide updates on the QuEST (Quality, Excellence, Staffing, Teamwork) VBP initiative, including upcoming methodology changes planned for Calendar Year 2026 and 2027.  

Meeting Date &Time 

Wednesday, October 15, 2025, 2:00 PM to 3:00 PM 

Registration Link 

Meeting Registration – Zoom  

Syringe Services Programs Rule, 10-144 CMR Ch. 252

The Department is proposing to amend Maine's Syringe Services Programs Rule (10-144 CMR Chapter 252) to implement recently enacted 22 M.R.S. § 1341(5), which expressly permits a certified hypode1mic apparatus exchange program (also known as a syringe service program or SSP) to operate mobile sites and offer delivery services, and further clarify the parameters under which SSPs may operate, including by establishing a geographic zone or "Operation Area" for each SSP. The Department is proposing rule provisions that prohibit SSPs from operating within 1,000 feet of school property; amendments to clarify the application process prescribed by the Department for SSP certification, program operations and staff training requirements; changes to require proof of compliance with municipal zoning ordinances and local regulations within the designated Operation Area; and changes that revise data reporting requirements by directing SSPs to submit monthly data electronically as prescribed by this rule. Additionally, the Department is proposing changes to the definition section by adding, removing and amending terms, as well as changes to update rule format. Date, time and location of PUBLIC HEARING (if any): Monday, October 20, 2025 COMMENT DEADLINE: Friday, October 31, 2025 1-4pm, Conference Rm. Maine A & B 109 Capitol Street Augusta, Maine 04330 CONTACT PERSON FOR TIIIS FILING (include name, mailing address, telephone, fax, TTY, email): Bridget Danis, Policy Analyst; 286 Water Street - l l State House Station, Augusta, ME, 04333-001 l; Tel: 287-9394 or 711 (TTY); Fax: 287-2887; Bridget.Danis@maine.gov

Elimination of Mailing Paper Remittance Advice (RA) and Reduction of Paper Checks, CR 132320

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 receiving 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.

HIV Prevention for Medical Practitioners

The Department is offering a series of HIV focused webinars. The first, led by Dr. Stephen Rawlings, covers the latest in HIV pre-exposure prophylaxis (PrEP) including a review of the twice-yearly injectable PrEP drug Yeztugo.

Dr. Rawlings, a MaineHealth practitioner, is Board certified in Infectious Diseases and Internal Medicine. He seeks opportunities to teach at all levels so that we can all enjoy the best medical care possible.

Children’s Behavioral Health & Residential Treatment

Applying for Children’s Residential Care Facility Services

CBHS contracts with Acentra to manage Children’s Residential Care Facility Services (CRCF). Children’s Residential Care Facility Services for children follows the MaineCare Section 97 eligibility criteria. Acentra processes all applications and completes Prior Authorizations for Children’s Residential Care Facility Services, and they are your contact related to approval for admissions to Children’s Residential Care Facility.

10-148 C.M.R. ch. 31; Quality Rating and Improvement System: Rising Stars for ME

This rule outlines how the Maine Department of Health and Human Services (the Department) pays a differential rate for child care services that meets or that makes substantial progress toward meeting nationally recognized quality standards, as required by 22 M.R.S.A § 3737. The emergency rulemaking allows the Department to immediately start paying a higher quality differential to such early care and education programs, addressing the lack of access to high-quality early care and education programs in Maine, which presents an ongoing threat to Maine’s general welfare.

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