MaineCare Bulletins

Date Title Topic
Apply to Present at MaineCare’s Delivery System Reform (DSR) Annual Forum Behavioral Health (BH), Primary Care and Care Coordination
Section 67, Nursing Facility (NF) Reform – Phase II Specialty Care Draft Rate Model Presented Materials and Comment Deadline Long Term Care Services
Microdyn Update for Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) – CRs 133841, 133842, 133900 Hospital & Clinic Services
UPDATE for Prescribing Providers who Must Enroll in MaineCare General, All Services
Improving Customer Service Efficiency and Accuracy with Customer/Case Authentication for Behavioral Health Providers Behavioral Health (BH)
Maine’s Transforming Maternal Health (TMaH) Model Public Informational Webinar General, All Services
MaineCare Notice of Agency Emergency Rule-making Adoption, MaineCare Benefits Manual, Chapter III, Section 45, Principles of Reimbursement for Hospital Services State & Federal Policy
Quarterly Physician Drug Code and Rate Update: QTR 3, CR 133662 Hospital & Clinic Services
Home and Community Based Supports (HCBS) Sections 18, 20, 21, 29, and New Lifespan Waiver: Review of Final Draft Rates & Models Long Term Services and Supports
Provider Responsibility for Managing Users in my Health PAS Trading Partner Accounts (TPA) General, All Services
Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840 General, All Services
Apply to Present at MaineCare’s Delivery System Reform (DSR) Annual Forum General, All Services
Section 67, Nursing Facility (NF) Reform - Phase II Specialty Care for Individuals with Acquired Brain Injury or Medical-Psychiatric Needs: Draft Rate Model Public Review & Comment and Phase I Value-Based Purchasing (VBP) Updates Long Term Care Services
Section 3, Primary Care Plus (PCPlus) – Rate Determination Kickoff Meeting & Model Advancement Overview Presented Materials Primary Care and Care Coordination
Revalidate with MaineCare to Avoid Claim Denials General, All Services
Apply to Present at MaineCare’s Delivery System Reform (DSR) Annual Forum Behavioral Health (BH), Primary Care and Care Coordination
CORRECTION: Apply to Present at MaineCare’s Delivery System Reform (DSR) Annual Forum Behavioral Health (BH), Primary Care and Care Coordination
Retro Physician Drug Rate Updates: Effective July 2024 – June 2025, CR 133663 Hospital & Clinic Services
Primary Care Plus (PCPlus) Quality Webinar: Controlling High Blood Pressure Primary Care and Care Coordination
Updated Guidance for Continued Stay Reviews (CSR) in Section 97 Private Non-Medical Institution (PNMI) Appendix E Behavioral Health (BH)
Health PAS Online Portal Down Time Update Critical Communications
Payment Error Rate Measurement (PERM) Reporting Year (RY) 2024 Errors General, All Services
RESCHEDULED: Primary Care Plus (PCPlus) Model Advancement Kickoff Meeting and PCPlus Phase II Alternative Payment Model (APM) Design Kick-off Meeting Primary Care and Care Coordination
MaineCare Benefits Manual (MBM), Chapter VI, Section 3, Primary Care Plus (PCPlus) – Rate Determination Kickoff Meeting & Primary Care Utilization Review Meeting General, All Services, Primary Care and Care Coordination
MaineCare Notice of Agency Waiver Renewal State & Federal Policy
Tips and Tricks for Password and Username Resets on the Health PAS Online Portal, CR 131667 General, All Services
Guidance for Section 65 Medication Management Code Changes and Duplication with Intensive Outpatient Programs (IOP) Behavioral Health (BH)
New Health PAS Online Portal Downtimes Critical Communications
Section 65, Mobile Crisis Intervention Response Services – Final Draft Rate Model Presented Materials, Comment Summary with Department Response, and Final Draft Rates Behavioral Health (BH)
Billing Requirement for the Emergency Services Limited Benefit Package Hospital & Clinic Services
Prescribing Providers Must Enroll in MaineCare Dental Services, General, All Services
Section 97, Appendix C, Residential Care Facilities (RCFs): Implementation of Part AAAA Adjustment Long Term Care Services
Section 50, Intermediate Care Facilities (ICF) Rate Letters for Fiscal Year 2026 (FY26) and Day Habilitation Service Rate Update – CR 133180 Long Term Care Services
Sections 21 & 29: July 1, 2025, Cost-of-Living Adjustments (COLAs) Implemented Long Term Services and Supports
Primary Care Plus (PCPlus) Model Advancement Meeting Primary Care and Care Coordination
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
Disclosures of Organizational Change Reminder General, All Services
MaineCare Provider Training Opportunities 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