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System Maintenance from April 23, 2022 to April 24, 2022 |
General, All Services |
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Attention Providers of Sections 31 Federally Qualified Health Center (FQHC) Services and 103 Rural Health Clinic (RHC) Services: National Correct Coding Initiative (NCCI) Change of Edit 6075 from Warn to Deny, CR 106771 and 108825 |
Primary Care and Care Coordination |
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Pharmacy Point of Sale (POS) Blackout Period April 20, 2022 |
Retail Pharmacies |
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Primary Care Plus (PCPlus) Year One Final Application Period Now Open |
Not in use |
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Primary Care Plus (PCPlus) Year One Final Application Period Now Open |
Primary Care and Care Coordination |
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2022 Rate Updates for Medical Imaging Codes, CR 107225 |
General, All Services |
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Dental Problems with Buprenorphine Dissolved in The Mouth to Treat Opioid Use Disorder (OUD) and Pain |
Behavioral Health (BH) |
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Dental Problems with Buprenorphine Dissolved in The Mouth to Treat Opioid Use Disorder (OUD) and Pain |
Primary Care and Care Coordination |
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Dental Problems with Buprenorphine Dissolved in The Mouth to Treat Opioid Use Disorder (OUD) and Pain |
Hospital & Clinic Services |
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Dental Problems with Buprenorphine Dissolved in The Mouth to Treat Opioid Use Disorder (OUD) and Pain |
Dental Services |
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No Prior Authorization (PA) Needed for Insulin Used During Pregnancy |
Retail Pharmacies |
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No Prior Authorization (PA) Needed for Insulin Used During Pregnancy |
Hospital & Clinic Services |
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No Prior Authorization (PA) Needed for Insulin Used During Pregnancy |
Primary Care and Care Coordination |
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Electronic Visit Verification (EVV) Frequently Asked Questions (FAQs) |
Long Term Services and Supports |
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Electronic Visit Verification (EVV) Frequently Asked Questions (FAQs) |
Not in use |
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Rate Updates |
General, All Services |
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System Maintenance from April 9, 2022 to April 10, 2022 |
General, All Services |
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MaineCare Updated COVID-19 Vaccine Administration Rate, CR 107185 |
General, All Services |
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Microdyn Updates for Ambulatory Payment Classifications (APC), CRs 107154 & 107155 |
Hospital & Clinic Services |
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The Impact of Bias and Microaggressions Webinar |
Behavioral Health (BH) |
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Attention Providers of Sections 67, Nursing Facility (NF), 97, Residential Care Facility (RCF or PNMI Appendix C), and 2, Adult Family Care Homes (AFCH) |
Long Term Care Services |
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Attention Private Non-Medical Intuition (PNMI) Appendix B Providers: Maintenance Case Needed for New Specialty Added to Provider Type 55 – PNMI, CR 100507 |
Behavioral Health (BH) |
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Notice of Agency Rule-making Proposal: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder |
State & Federal Policy |
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Notice of Agency Rule-making Proposal: 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 21, Allowances for Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder |
State & Federal Policy |
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MaineCare Job Openings |
General, All Services |
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Attention Providers of Sections 67, Nursing Facility (NF), 97, Residential Care Facility (RCF or PNMI Appendix C), and 2, Adult Family Care Homes (AFCH) |
Long Term Care Services |
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Attention Durable Medical Equipment (DME) Providers: New Rates for Ostomy Equipment and Supplies |
Specialty Services |
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Notice of Agency Rule-making Adoption: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder |
State & Federal Policy |
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Notice of Agency Rule-making Adoption: 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 21, Allowances for Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder |
State & Federal Policy |
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Notice of Agency Rule-making Adoption: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder |
State & Federal Policy |
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Notice of Agency Rule-making Adoption: Chapter 101, MaineCare Benefits Manual, Chapter III, Section 21, Allowances for Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder |
State & Federal Policy |
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Reimbursement for COVID-19 Testing, Treatment, and Vaccination Services for Uninsured Individuals |
General, All Services |
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Integrating Care for Perinatal Populations with Opioid Use Disorder Online Webinar |
Hospital & Clinic Services |
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Integrating Care for Perinatal Populations with Opioid Use Disorder Online Webinar |
Behavioral Health (BH) |
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Integrating Care for Perinatal Populations with Opioid Use Disorder Online Webinar |
Not in use |
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Claim Denials for No Attending Provider on UB-04 and 837I Claims, CR 107682 |
General, All Services |
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Notice of Agency Rule-making Proposal: Chapter 101, MaineCare Benefits Manual, Chapters II & III, Section 93, Opioid Health Home Services |
State & Federal Policy |
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Ambulance Services Reimbursement and Locality Modifiers, CR 108340 |
Hospital, Family Planning, and Ambulatory Care/Clinic Services |
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Ambulance Services Reimbursement and Locality Modifiers, CR 108340 |
Specialty Services |
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Payments to Home and Community-Based Services (HCBS) Providers |
Long Term Care Services |
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Payments to Home and Community-Based Services (HCBS) Providers |
School Health Related Services |
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Payments to Home and Community-Based Services (HCBS) Providers |
Behavioral Health (BH) |
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Payments to Home and Community-Based Services (HCBS) Providers |
Long Term Services and Supports |
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Payments to Home and Community-Based Services (HCBS) Providers |
Primary Care and Care Coordination |
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System Maintenance from March 19, 2022 to March 20, 2022 |
General, All Services |
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Use of Palivizumab Prophylaxis to Prevent Hospitalization from Severe Respiratory Syncytial Virus (RSV) Infection |
Retail Pharmacies |
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Use of Palivizumab Prophylaxis to Prevent Hospitalization from Severe Respiratory Syncytial Virus (RSV) Infection |
Primary Care and Care Coordination |
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Nursing Facility (NF) and Residential Care Facility (PNMI Appendix C) Rates are Available for Billing |
Long Term Care Services |
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Notice of Agency Rule-making Adoption: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Section 97, Private Non-Medical Institution Services, Ch. III |
State & Federal Policy |
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System Maintenance from March 19, 2022 to March 20, 2022 |
General, All Services |