Sections 14, 30, 31, 45, 90 & 103, Certain Medicare Covered Family Planning Services and Long-Acting Reversible Contraception (LARCs): Draft Rates Public Review & Comment Deadline

Public Review & Comment 

On September 30, 2024, MaineCare held an online public meeting to present draft rates along with the rationale for certain Medicare covered Family Planning Services and LARCs. Interested parties had the opportunity to provide public comments.  

The Department will accept written comments until October 14, 2024, and respond in writing to those comments with an explanation of whether and how the feedback was incorporated into the final rate determination. 

Attention HCBS Providers of Therapeutic Intervention Services for Sections 19, 20, 21, & 40: Interested Parties Engagement Session Presented Materials

As previously noticed, MaineCare and its vendor are hosting several engagement sessions with interested parties to obtain important feedback as part of the rate determination process that was initiated in June of 2024, for certain HCBS services.   

Pharmacy Copayments Return with the End of the American Rescue Plan (ARP) Act on September 30, 2024

In accordance with federal requirements set forth in ARP, MaineCare covers COVID-19 testing, treatment, vaccine, and vaccine administration without cost sharing, for all MaineCare members through September 30, 2024. To comply with this requirement, MaineCare waived copayments for Section 80: Pharmacy Services. 

Effective October 1, 2024: 

Attention HCBS Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, Assistive Technology Services, & Personal Support Services: Engagement Session Questions and Answers (Q&A)

As previously noticed, MaineCare and its vendor are hosting several engagement sessions with interested parties to obtain important feedback as part of the rate determination process for certain HCBS services that was initiated in June of 2024.

Important Coverage Information: End of the American Rescue Plan Act (ARPA) Period

At the beginning of the COVID-19 pandemic, the federal government relaxed certain requirements to promote continued access to healthcare services for members enrolled in Medicaid. ARPA enabled MaineCare to cover through September 30, 2024, certain COVID-19 related services which were otherwise not covered under the MaineCare Benefits Manual (MBM).

Important Copayment Information: End of the American Rescue Plan Act (ARPA) Exemption on Copays

At the beginning of the COVID-19 pandemic, the federal government relaxed certain requirements to promote continued access to healthcare services for members enrolled in Medicaid. ARPA allows states to cover COVID-19 vaccination, testing, and treatment without member cost sharing through September 30, 2024.

Beginning on October 1, 2024, MaineCare will reinstate copayments (copays) which had been waived for certain services.  

Reinstated Copayments

Attention HCBS Providers of Supportive Skills Building Services for Sections 12, 18, 19, 20, 29, & 96: Interested Parties Engagement Session Presented Materials

As previously noticed, MaineCare and its vendor are hosting several engagement sessions with interested parties to obtain important feedback as part of the rate determination process that was initiated in June of 2024, for certain HCBS services. 

MaineCare Notice of Agency Rule-making Adoption, Chapter II, Section 25, Dental Services and Reimbursement Methodology

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.

MaineCare Notice of Agency Rule-making Adoption, Chapter II, Section 25, Dental Services and Reimbursement Methodology

Notice of Agency Rule-making Adoption

AGENCY:  Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND TITLE:  10-144 C.M.R, Chapter 101, Chapter II, Section 25, Dental Services and Reimbursement Methodology

ADOPTED RULE NUMBER:

CONCISE SUMMARY:  

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