• Read more about Claims Pending for Missing Vendor Code​

The Office of MaineCare Services (OMS) has become aware of a vendor code issue that began this morning, May 1, 2024, impacting certain provider’s claims and causing those claims to go into a PEND status for a Missing Vendor Code (Edit 6037). This issue is being investigated and addressed by multiple entities including: OMS, Gainwell Technologies, and the Office of the State Controller. OMS will update all providers as this issue progresses. 

Please note that this issue will NOT impact any provider’s payments issued this week. 

• Read more about ​Public Forum Postponed: Section 45, Hospital Service Providers Draft Reimbursement Methodologies​​

The public review and comment forum that was scheduled for May 7, 2024, to present the draft rates and methodologies for Section 45 services has been postponed. We appreciate your ongoing patience and apologize for any inconvenience. The Department will reschedule this forum and send notice of the new date and time. Please watch for future noticing.  

For questions, please contact Jessica Levesque, MaineCare’s Rate Reform Project Manager.  

• Read more about MaineCare Notice of Agency Major Substantive Rulemaking Adoption, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder

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 t

• Read more about MaineCare Notice of Agency Major Substantive Rulemaking Adoption, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder

Notice of Agency Major Substantive Rulemaking Adoption

AGENCY:  Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder

PROPOSED RULE NUMBER: 2023-P173

CONCISE SUMMARY:

• Read more about Attention Pharmacy Providers: Status of Restoration of Maine Point of Purchase System (MEPOPS) and Updated Technical Instructions for Processing Backlogged Claims

The Office of MaineCare Services thanks pharmacy providers for transmitting claims with dates of service during the outage period (February 21, 2024, through March 26, 2024).

• Read more about Maine Office of Child and Family Services Joins National Partnership for Child Safety

Partnership advances Safety Science implementation and plan to keep children safe by keeping families strong

AUGUSTA– The Maine Department of Health and Human Services' (DHHS) Office of Child and Family Services (OCFS) announced today that it has joined the National Partnership for Child Safety (NPCS), a quality improvement collaborative with a mission to improve child safety and prevent child maltreatment fatalities.

• Read more about Electronic Visit Verification (EVV) Online Training Available

There are no additional live trainings for EVV scheduled after April 25, 2024. Providers can request Ad Hoc EVV Training by emailing MihmsTraining@gainwelltechnologies.com to schedule a training.

Register for online trainings through Absorb: 

• Read more about Mills Administration Hosts 2024 Health Workforce Summit

With health care jobs rebounded from the pandemic, Maine Departments of Health and Human Services and Labor convene health care leaders and innovators to advance progress in recruiting and retaining workers

• Read more about Section 31, Federally Qualified Health Centers (FQHCs) – Rate Determination Comment Summary with Department Response

In September of 2022, the Office of MaineCare Services initiated a rate determination process for Section 31, FQHCs, pursuant to MRS Title 22, §3173-J, to develop an alternative payment model in alignment with requirements identified in MRS Title 22, §3173-V. In March of 2023 MaineCare along with its vendor, Guidehouse Inc., hosted a

• Read more about Attention Section 101, Imaging Service Providers: REVISED Calendar Year 2024 Medicare Standardization Rates, CR 124059

In coordination with the Centers for Medicare & Medicaid Services (CMS) revision of rates effective March 9, 2024, MaineCare has updated its Section 101 rates. These rates were implemented on April 17, 2024.