• Read more about Attention Primary Care Plus (PCPlus) Practices - PCPlus Application and Recertification Opening – Required for all PCPlus Practices

MaineCare Services is pleased to announce that the PCPlus application period is now open. The open application period runs through Friday, May 3, 2024. 

PCPlus is a MaineCare primary care model that gives Primary Care Provider (PCPs) greater flexibility and incentives to meet MaineCare members’ healthcare needs by transitioning away from a volume-based (fee-for-service) payment system toward population-based payments tied to cost and quality-related outcomes. Participation in PCPlus is voluntary for PCPs, and PCPs must apply to participate.    

• Read more about Attention Pharmacy Providers: Service Disruption 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 04, 2024, from 3:30 PM – 4:15 PM related to the current service disruption. 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:

• Read more about MaineCare Launches Initial Restoration of Pharmacy Claims System

Pharmacies resume billing for MaineCare members' prescriptions, following vendor disruption

AUGUSTA– The Maine Department of Health and Human Services (DHHS) announced today that pharmacies have resumed billing MaineCare for members' prescriptions, following the disruption to its pharmacy claims system due to the national cyber security issue affecting Change Healthcare.

• Read more about Attention Providers: Update on Phased Restoration of Change Healthcare Systems

MaineCare continues to advise providers to submit documentation electronically to avoid delays in items submitted by mail and/or fax, following the disruption related to the national cyber security issue with Change Healthcare.

• Read more about Attention Pharmacy Providers: Confirmed Initial Restoration of Maine Point of Purchase System (MEPOPS) on March 27, 2024

MaineCare successfully initiated the first phase of restoration of MEPOPS today, March 27, 2024. This follows the disruption that occurred on February 21, 2024, due to the national cyber security issue affecting Change Healthcare.

• Read more about ​Public Review Rescheduled: Section 25, Dental Service Providers Benchmarking Results and Draft Rates​​

The public review and comment forum that was scheduled for March 29, 2023, has been rescheduled to April 12, 2024. The Department requires additional time to ensure a clear and transparent presentation of the draft rates and methods. We appreciate your patience and apologize for any inconvenience.  

• Read more about Attention Providers: Submit Documentation Electronically to Avoid Delays

As communicated on February 23, 2024, Change Healthcare is experiencing a network interruption related to a cyber security issue. This is a national issue affecting health care systems and Medicaid programs in many states, including Maine.  

• Read more about 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.  andThe taxonomy is also used by helping CMS to conduct program oversight, administration, and integrity.  

• 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.

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 Attention Pharmacy Providers: Resharing a Scheduling Link - Maine Point of Purchase System (MEPOPS) will return to service on March 27, 2024

*For those who experienced difficulties accessing the link in our previous message to schedule Provider Help Desk afterhours support, please see updated instructions bolded below.