Microdyn Update for Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) – CRs 133841, 133842, 133900

Effective August 23, 2025, we completed the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates in MIHMS. The following CMS documents provide the details of the APC and DRG updates:   

July 2025 Integrated Outpatient Code Editor Specs

July 2025 Update of Hospital Outpatient Prospective Payment System (OPPS)

10-144 CMR Ch 108 Home and Community Support Services Agency Licensing Rule EMERGENCY RULE

This emergency rulemaking operationalizes the statutory requirements of 34-B M.R.S. § 1203-B, Licenses for agencies that provide services to adults with certain conditions. Under this statute, any agency that provides a service, if that service is funded in whole or in part by the Department, to an adult with an intellectual disability, autism spectrum disorder, a related condition or an acquired brain injury, including a service provided under 22 M.R.S.

10-144 CMR Ch 108 Home and Community Support Service Agencies Licensing Rule

This routine technical rulemaking operationalizes the statutory requirements of 34-B MRS 1203-B, Licenses for agencies that provide services to adults with certain conditions.  Under this rule, any agency that provides a service, if that service is funded in whole or in part by the Department, to an adult with an intellectual disability, autism spectrum disorder, a related condition or an acquired brain injury, including a service provided under 22 M.R.S.

10-144 C.M.R. Ch. 331; Public Assistance Manual Temporary Assistance for Needy Families (TANF) - Maximum Benefit and Standard of Need Chart

10-144 C.M.R. Chapter 331; Public Assistance Manual Temporary Assistance for Needy Families (TANF)

Maximum Benefit and Standard of Need Chart

TANF Rule #125P – COLA Update

The Department proposes routine technical updates to 10-144 C.M.R. Ch. 331; Public Assistance Manual Temporary Assistance for Needy Families (TANF) consistent with legislative changes made to 22 M.R.S. § 3769-C(1)(D) made by P.L. 2023, Ch. 622, § 2.

Maine’s Transforming Maternal Health (TMaH) Model Public Informational Webinar

As announced in January 2025, the Office of MaineCare Services (OMS) is one of 15 state Medicaid programs selected to participate in the Transforming Maternal Health (TMaH) Model. This is a 10-year initiative supported by the Centers for Medicare & Medicaid Services (CMS) designed to improve maternal and newborn health outcomes for people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP).

Improving Customer Service Efficiency and Accuracy with Customer/Case Authentication for Behavioral Health Providers

Starting September 4, 2025, Acentra Health is implementing an automated caller authentication system to enhance security and improve customer service efficiency.

When contacting Acentra Health, both member and provider callers are prompted to answer various identifying questions to authenticate and connect the caller to the appropriate member or case record.

Examples of authentication prompts:

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