• Read more about Help MaineCare Members Avoid a Gap in Health Coverage

As you may know, changes are coming to MaineCare, and the Maine Department of Health and Human Services is hoping that pharmacies can help to spread the word!

We are working to raise awareness about the need for people with MaineCare to renew their coverage or, if they’re no longer eligible, to enroll in coverage through their employer or through CoverME.gov, Maine’s Health Insurance Marketplace. 

More information about this process can be found at MaineCare.gov/unwinding.

• 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 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 MaineCare for Kids Communications Toolkit

Effective October 1, 2023, the Maine Department of Health and Human Services has expanded eligibility for children and young adults under 21 in Maine to include family incomes up to 300% of the federal poverty level. That translates to an annual salary of about $59,000 for a family of two and $90,000 for a family of four. Additionally, the Department eliminated most premiums for children’s coverage, effective March 1, 2023.

• Read more about Update to the ​Biosimilar Preferred Drug List​

Effective January 4, 2024, the Department will add preferred and non-preferred drugs to the Biosimilar Preferred Drug List (PDL). 

The Department will add the following preferred drugs:  

• Read more about Impact to MaineCare of Average Manufacturer Price (AMP) Cap Removal

As the result of a provision in the American Rescue Plan (ARP) Act of 2021, beginning January 1, 2024, Medicaid rebates from drug manufacturers will no longer be capped at 100 percent of the quarterly AMP. 

• Read more about ​​EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) App ​

EVV Providers who are currently using the SMC app through their phone, tablet, or other mobile device should update to the latest version of the app using the Apple Store, or Google Play. The current version of the app is being phased out and will no longer be active. To avoid any interruption of visit record keeping, you should now download the app that has a version number of 3.0 or higher.   

• Read more about CORRECTION: Non-Billing, Ordering, Prescribing, and Referring (NOPR) Editing Changing from Warn to Deny – CR 121469

This message serves as a correction to information provided in our December 27th e-message regarding Non-Billing, Ordering, Prescribing, and Referring (NOPR) Edits.

• Read more about CORRECTION: Intermediate Care Facilities (ICF) Rate Letters for CY 2024 and Day Habilitation Service Rate Update – CR 121701 ​

This notice corrects our earlier reference to Section 50 as an Intensive Care Facility. Section 50 is an Intermediate Care Facility.  

Rate Letters  

• Read more about ​​Section 50, Intensive Care Facilities (ICF) Rate Letters for Calendar Year (CY) 2024 and Day Habilitation Service Rate Update - CR 121701

Rate Letters 

The CY 2024, ICF-IID rate letters are now available on the Health PAS Online Portal. You can view them by logging into your Trading Partner Account and following this pathway: File Exchange > Reports > Rate Setting Letters.  

• Read more about ​Section 103, Rural Health Center (RHC) Calendar Year 2024 (CY24) Rate Update - CR 121608

Effective January 1, 2024, the Section 103, RHC CY24 rate letters will be accessible on the secure Health PAS Online Portal. You can view them by logging into your Trading Partner Account and following this pathway: Exchange > Reports > Rate Setting Letters.