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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.
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
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EVV Phase 2 Training and Aggregator Content – State and Provider Trainings |
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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.
On December 11, 2023, MaineCare in coordination with its vendor Burns and Associates, a Division of Health Management Associates (HMA-Burns), hosted a virtual public forum via Zoom for interested providers and stakeholders. We presented an initial recommended draft reimbursement methodology and rationale for inpatient services in acute care and rehabilitative hospitals.
MaineCare covers Food and Drug Administration (FDA) approved and FDA Emergency Use Authorized (EUA) over the counter (OTC) COVID-19 home tests through a Standing Order for MaineCare beneficiaries. COVID-19 tests will be covered with no member cost sharing.
MaineCare, in collaboration with Maine Center for Disease Control, is hosting a webinar focusing on the collaboration between PCPlus practices and Community Health Workers (CHWs) or Community-Based Organizations (CBOs) employing CHWs. The goal of this webinar is to:
Provide a brief overview of the CHW workforce in Maine
Provide an overview of incentives within PCPlus to increase access to CHW services
In response to provider inquiries regarding ACT, the Department updated the January 1, 2023 Behavioral Health Rate Adjustments Frequently Asked Questions.
For questions, please contact provider relations specialist, Bruce Cosgrove.
On May 1, 2023, the Office of MaineCare Services (OMS) released guidance related to billing and implementation of the updated APM for FQHCs.
In follow up to our January 19, 2024 notice, service codes and rates for Section 101, of the MaineCare Benefits Manual are now implemented, effective January 1, 2024, to reflect 72.4% of the most recent 2024 Medicare rates.
Adjustment of Claims
Department also unveils more details about plan from Governor’s State of the State to improve child safety, announcing that the forthcoming supplemental budget will include nearly $7 million in initiatives to strengthen child welfare system