• Read more about Section 30, Family Planning, Implementation of Base Rate and Resulting Final Rate, CR 122825

Effective January 1, 2024, the Department has updated the base rates and resulting final rates for certain Family Planning Services delivered by eligible providers. These new rates were implemented for billing on February 15, 2024.

Only providers engaged primarily in the delivery of sexual and reproductive health care services, as described in 42 United States Code, Section 1396d(a)(4)(c) are eligible to bill add-on rates. 

• Read more about Attention Section 90, Enhanced Primary Care Providers: REVISED Calendar Year 2023 (CY23) Rates - CR 116094

On July 19, 2023, the Department implemented the revised rates for Enhanced Primary Care Provider services, effective January 1, 2023.

Adjustment of Claims

• Read more about Training Opportunity Available for Section 19 Home and Community Based Services for Older and Disabled Adult Caregivers

The Office of Aging and Disability Services is excited to announce a virtual training opportunity scheduled for Monday, March 18, 2024- Mental Health First Aid. This training is being provided under collaboration with the National Alliance on Mental Illness (NAMI) Maine and is available for caregivers providing care to Section 19 members. Caregivers can include personal support staff, attendants, home health aides, CNAs, nurses or other natural and family supports.

• Read more about Provider Survey- Attitudes Towards Contingency Management (CM) for Treatment of Substance Use Disorder (SUD)

The Department of Health and Human Services is partnering with the Substance Use Research & Evaluation (SURE) unit at the Catherine E. Cutler Institute, University of Southern Maine to evaluate the system of care for SUD. We have identified that more information is needed to understand attitudes of providers towards CM within the SUD continuum of care. To assist the Department, the SURE unit developed an electronic survey of provider beliefs about CM as a treatment option for SUD.

• Read more about Maine DHHS: Governor’s Proposed $30 Million Will Strengthen Behavioral Health System

Investments proposed in Governor Mills’ supplemental budget support providers, services for adults and children, and advance violence prevention and public safety

• Read more about Correction: Taxonomy Code Requested on Claim Submissions – Portal Claims

The Office of MaineCare Services (OMS) is requesting that providers include the taxonomy code on all claims. The taxonomy code is necessary for the Centers for Medicaid and Medicare Services (CMS) to collect data for Transformed Medicaid Statistical Information System (T-MSIS) reporting. This data helps to inform states of their current standing in data quality as compared to other states and is crucial for research and policy on Medicaid and CHIP and helping the Centers for Medicare & Medicaid Services (CMS) conduct program oversight, administration, and integrity.  

Feb 2, 2024

The Maine Department of Health and Human Services is prioritizing a comprehensive outreach effort to ensure MaineCare (Medicaid) members know they need to connect with the Department to continue their coverage.

As part of the resumption of eligibility reviews after the COVID-19 Public Health Emergency, known as “unwinding,” the Department is reviewing the eligibility of all MaineCare members. DHHS outreach is focused on make sure members know the steps to take to avoid unnecessarily losing coverage. Efforts include:

• Read more about Maine DHHS reaching out to Maine people to keep them covered

• Read more about Provider Enrollment Presentation Follow-Up and Progress Update

On January 17, 2024, the Office of MaineCare Services (OMS) and Gainwell held a listening session about provider enrollment. During this session, providers asked questions and shared suggestions about how to improve the enrollment, revalidation, and maintenance case submission process and case review process. We appreciate the time that providers took to attend, participate, and share their ideas to improve these processes.

• Read more about Electronic Visit Verification (EVV) Phase 2 Trainings

The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.

We continue to offer weekly EVV provider and aggregator trainings. All trainings are online via Microsoft Teams.

NOTE: The Absorb training system has been updated to allow providers to register for trainings more than once.

EVV Training Schedule

• Read more about Taxonomy Code Requested on Claim Submissions

The Office of MaineCare Services (OMS) is requesting that providers include the taxonomy code on all claims. The taxonomy code is necessary for the Centers for Medicaid and Medicare Services (CMS) to collect data for Transformed Medicaid Statistical Information System (T-MSIS) reporting. This data helps to inform states of their current standing in data quality as compared to other states and is crucial for research and policy on Medicaid and CHIP and helping the Centers for Medicare & Medicaid Services (CMS) conduct program oversight, administration, and integrity.