MaineCare Bulletins

Date Title Topic
Attention Providers: System Maintenance Disrupting Provider Maintenance Cases General, All Services
Sections 18, 20 & 65: July 1, 2025, Cost-of-Living Adjustments (COLAs) Implemented Behavioral Health (BH), Long Term Services and Supports
System Maintenance Complete and Provider Maintenance Cases Resume General, All Services
MaineCare Provider Training Opportunities General, All Services
Disclosures of Organizational Change Reminder General, All Services
Section 31, Federally Qualified Health Centers (FQHCs) Retroactive Cost-of-Living Adjustment (COLA) Primary Care and Care Coordination
Sections 91 & 93: Health Home Services - Community Care Teams (91) and Opioid Health Home Services (93) – Cost-of Living Adjustments (COLAs) Behavioral Health (BH)
Section 45 Hospitals: Cost-of-Living Adjustments (COLAs) Hospital & Clinic Services
Section 97, Appendix C, Residential Care Facilities (RCFs) Cost-of-Living (COLA) & AAAA Adjustments Long Term Care Services
Sections 23, 25, 30, 40, 89, 91, 93, 97 B & D, 102: July Cost-of-Living Adjustments (COLAs) General, All Services
Status of 1.95% Cost-of-Living Adjustments (COLAs) for Sections 2,12,13,17,18,19, 20, 21, 26, 28, 29, 65, 96, 97C General, All Services
Rate Determination Initiation Notice: New Section, 106 School Health-Related Services and New Service, Section 65 Multi-Dimensional Family Therapy (MDFT) General, All Services
Final Rate Model: Section 65, Mobile Crisis Intervention Response Service Behavioral Health (BH)
Primary Care Plus (PCPlus) Model Advancement Meeting Primary Care and Care Coordination
Final Rate Determination Schedule Calendar Year 2025 (CY25) and Comment Summary General, All Services
Attention MaineCare Providers: Plans to Release Payments Pended During Temporary MaineCare Payment Holds – June 16, 2025 Critical Communications
Section 97, Private Non-Medical Institutions, Appendix F (PNMI-F): Rate Letters for Fiscal Year (FY) 2026, CR,132604 Long Term Care Services
Rounding Rule Clarification General, All Services
MaineCare Issued Annual Hospital Value-Based Purchasing (VBP) Supplemental Payments Hospital & Clinic Services
Billing Reminder: When Services are Rendered Via Telehealth Critical Communications, Behavioral Health (BH), Dental Services, General, All Services, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Primary Care and Care Coordination, School Health Related Services, Specialty Services
Licensing Requirements for ​Intensive Outpatient Program (IOP) Providers Behavioral Health (BH)
Section 92, Behavioral Health Homes (BHH) Cost-of-Living Adjustments (COLA) Behavioral Health (BH)
​2025 Home and Community Based Services (HCBS) Consumer Assessment of Healthcare Providers & Systems (CAHPS®) Survey​ Long Term Services and Supports
MaineCare Cost of Living Adjustments (COLAs) for Sections 12, 13, 17, 18, 19, 20, 21, 26, 28, 29, 65, 92, 96, and 97C General, All Services
Provider Responsibility for Managing Users in my Health PAS Trading Partner Accounts (TPA) General, All Services
Taxonomy Code Requested on Claim Submissions – Portal Claims General, All Services
Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840 General, All Services
Prescribing Providers Must Enroll in MaineCare Dental Services, General, All Services
Prescribing Providers Must Enroll in MaineCare General, All Services
Clarifications to Section 65 Medication Management Code Changes Behavioral Health (BH)
Revalidate with MaineCare to Avoid Claim Denials General, All Services
Microdyn Update for Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) - CRs 131553, 131554, & 131582 Hospital & Clinic Services
Quarterly Physician Drug Code and Rate Update: QTR 2, CR 131894 Hospital & Clinic Services
Section 65 Medication Management Code Changes Behavioral Health (BH)
Updated Secondary Billing Instructions General, All Services
Reminder: Providers Delivering Services Via Telehealth General, All Services, Retail Pharmacies
Payment Error Rate Measurement (PERM) Reporting Year (RY) 2024 Errors General, All Services
Nursing Facility (NF) Listening Session on Rates for Individuals with Brain Injury or Medical-Psychiatric Needs Long Term Care Services
Comment Deadline Extended: Home and Community Based Supports (HCBS) Sections 18, 20, 21, 29, and New Lifespan Waiver Long Term Services and Supports
Section 60, Durable Medical Equipment (DME) and Supplies: Annual Rate Adjustment - CR 130241 Specialty Services
Announcing an Exciting Change to MaineCare’s Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program for Children and Youth General, All Services
Attention Providers: Transforming Maternal Health (TMaH) Model & Maternal Health Rural Regional Planning Webinar General, All Services
Attention Providers: Important Update to Preferred Diabetic Supply List (PDSL) Retail Pharmacies
Nursing Facility (NF) Bariatric Care Document Available Long Term Care Services, Long Term Services and Supports
Section 55, Laboratory Services: January 1, 2025, Rate Update, CR 129908 Specialty Services
Section 45, Hospitals & Section 90, Physicians: 2024 & 2025 Drug Rate Updates Hospital & Clinic Services
Sections 18 and 20, Home and Community Based Services for Adults with Brain Injury or other Related Conditions: Rate Correction - CR 130249 Long Term Services and Supports
MaineCare Notice of Agency Rulemaking Adoption, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities State & Federal Policy
CORRECTION: Home and Community Based Supports (HCBS) Sections 18, 20, 21, 29, and New Lifespan Waiver: Presented Materials and Comment Deadline Long Term Services and Supports
Critical Communications: A New E-message Topic List Behavioral Health (BH), Dental Services, General, All Services, General Notifications for All Providers, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Primary Care and Care Coordination, Retail Pharmacies, School Health Related Services, Specialty Services, State & Federal Policy