Electronic Visit Verification (EVV) Training
EVV Sandata Trainings
All trainings are available online via Microsoft Teams. These events can be found in the Event Calendar on the Health PAS Online Portal.
Register through Absorb:
Attention Pharmacy Providers: Service Restoration Office Hours with MaineCare Pharmacy Benefit
MaineCare is inviting you to join the next Office Hours call with the MaineCare Pharmacy team on Thursday, April 25, 2024, from 09:00 AM – 9:45 AM related to the initial restoration of Maine Point of Purchase System (MEPOPS). We will use this time as an opportunity for sharing questions and concerns and providing technical support from the State.
Please register in advance for this meeting:
Attaching an Explanation of Benefits (EOB) to Secondary Claims
When billing MaineCare secondary claims, you must attach an EOBA to all claims regardless of the submission type listed below:
- Direct Data Entry (DDE)
- Paper
- Electronic Data Interchange (EDI)
When submitting electronically, upload the EOB once the claim is in MIHMS. The charges billed on the claim lines must match the charges billed on the EOB, or the claim will be denied.
Webinar: What Primary Care Providers Need to Know About HIV
Maine was in the news recently for leading the nation in diagnosing HIV at late stage. To help primary care providers learn about HIV and AIDS, MaineCare is hosting a webinar, What Primary Care Providers Need to Know About HIV, on May 9, 2024, at 11:30 AM. This 30-minute free webinar will be led by Dr.
Attention Section 43 Hospice Services Providers: Electronic Visit Verification (EVV) Implementation Delayed Until Further Notice
As of March 15, 2023, MaineCare temporarily excluded hospice services from EVV requirements as a delayed enforcement of our approved State Plan requirements.
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 67, Nursing Facilities (NFs), Rate Determination Question & Answer Document Updated
On April 19, 2024, the Department updated the previously posted NF rate model Q&A document to provide additional clarifying information. Interested stakeholders are encouraged to review.
Annual 1115 Substance Use Disorder (SUD) Waiver Post Award Forum
On December 22, 2020, Maine DHHS announced the Center’s for Medicare & Medicaid Services (CMSs) approval of MaineCare’s waiver request, which lifts the federal restriction for residential or inpatient SUD treatment programs beyond 16 beds. The Implementation Plan was approved on July 26, 2021, which allows MaineCare to begin collecting federal funds for residential treatment facilities that expand their capacity.
MaineCare Provider Enrollment Progress Update
Gainwell continues to reduce the time it takes to complete their steps within the MaineCare enrollment process. Gainwell completed 559 enrollment cases in March and the average turnaround time for case completion was approximately 20 days. Case inventory was 578 at the end of March and the average system age of a case in inventory dropped to approximately 16.4 days old.
Additionally, to improve MaineCare enrollment, the Office of MaineCare Services (OMS) and Gainwell:
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter II, Section 94, Early and Periodic Screening, Diagnosis and Treatment Services (EPSDT)
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed rules on fi