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The Department will host an important educational call via Zoom for NF Administrators, Directors of Nursing, and other key members of your Quality Assurance Performance Improvement (QAPI) team on February 19, 2025, from 1:00 - 2:30 PM. The meeting will address quality components of the new NF payment model.
You may register through Zoom.
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services (DHHS), Office of MaineCare Services, Division of Policy
CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities
PROPOSED RULE NUMBER:
CONCISE SUMMARY:
On February 10, 2025, we shared that, if the Legislature does not pass the Fiscal Year 2025 supplemental budget request to fill the MaineCare shortfall, the Department will not have sufficient funds to pay MaineCare providers in full through the end of the fiscal year and will need to temporarily withhold
If your organization is going through an organizational change, please contact Gainwell to receive guidance before beginning an enrollment/revalidation/re-enrollment application or maintenance case and prior to submitting the Disclosure of Organizational Change for MaineCare form. This allows Gainwell/MaineCare to review the change and decide what is the best way the provider needs to enroll or update their enrollment.
Please contact the MaineCare Enrollment email box with questions.
All errors found during a PERM audit are considered improper payments.Maine is required to reimburse the federal government for all improper payments and has the right to seek recoupment from providers for improper payments resulting from provider error.
The most common errors found in the RY 2024 PERM Audit cycle are listed below. The most common errors from the previous two PERM cycles are also included in the list. Before submitting a claim, check that the information for the member and the services provided are accurate and complete.
It has come to our attention that not everyone who signed up for e-messages are receiving the notices we send through the General, All Services distribution list. We are working to resolve this issue. In the meantime, we are resending the e-message we sent on February 10, 2025.
The Department is proposing this routine technical rule change to amend Chapter 266, to coincide with the expiration of the emergency rule effective January 2, 2025, ensuring competency requirements and accreditation standards remain the standard for labs analyzing controlled substances seized by law enforcement and used in Maine’s courts’ procedures. The proposed non-emergency rule changes incorporate those emergency changes adopted by emergency rule to update the oversight authority and certification standards, including the educational and training requirements.
Plan Builds on Progress Uniting Communities, Organizations, and Leaders to Strengthen Support for Families
AUGUSTA-- The Maine Department of Health and Human Services (DHHS) and the Maine Child Welfare Action Network (MCWAN) today announced the release of Maine's Child Safety and Family Well-Being Plan (2025-2030), a comprehensive five-year plan aimed at promoting the safety and well-being of children in Maine by strengthening support for families.
In January, Governor Mills submitted to the Legislature a Fiscal Year 2025 supplemental budget request for $118 million in General Funds to align projected expenditures with available funding in the MaineCare program. The funding is available through new revenues recently recognized by the State of Maine’s nonpartisan Revenue Forecasting Committee. The Governor’s request must simply be approved by the Legislature in order for the funding to be appropriated to MaineCare.
Some of the 2025 rates for residential care facilities, PNMI Appendix C, were not updated. This caused claims to pay at the 2024 rates. We will update the rates in MIHMS and reprocess claims billed at the 2025 rates. No provider action is needed.
For questions, please contact Bruce Cosgrove, Provider Relations Specialist.