MaineCare Bulletins

Date Title Topic
EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) App Long Term Services and Supports
Rate Determination Initiation Notice for Home and Community Based Services (HCBS) Clinical, Therapy, Care Coordination, Supportive Skills Building, and Assistive Technology Services Long Term Services and Supports
Updated Guidance for Power Mobility Devices (PMD), CR 124323 Specialty Services
Attention Section 45, Hospital Distinct Psychiatric and Distinct Substance Use Disorder (SUD) Units: July 2024 Cost of Living Adjustment (COLA) Updates Hospital & Clinic Services
MaineCare Cost of Living Adjustments (COLAs) Effective July 1, 2024 General, All Services
Section 23, Developmental and Behavioral Clinic Services: Child Abuse Evaluations, Comment Summary and Final Draft Rate Behavioral Health (BH)
Section 31, Federally Qualified Health Centers (FQHCs) Annual Cost of Living Adjustments (COLAs) Effective July 1, 2024 Primary Care and Care Coordination
Recoupment of Claim Payments for Non-Covered Services Processed Under the COVID-19 Uninsured Benefit After the End of the Federal Public Health Emergency (PHE) General, All Services
RESCHEDULED: Section 45, Hospital Service Providers:  Public Forum Draft Reimbursement Methodologies  Hospital & Clinic Services
Electronic Visit Verification (EVV) Online Training Available Not in use
Apply to Present at the 2024 MaineCare Delivery System Reform Forums Behavioral Health (BH), General, All Services, Hospital & Clinic Services, Long Term Services and Supports, Not in use
Attention Providers of Section 17 and Section 92 Services Behavioral Health (BH)
Update**: MaineCare Cost of Living/“Part AAAA” Adjustments General, All Services
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 43, Hospice Services Not in use, State & Federal Policy
Dental Surgeries in Ambulatory Surgical Centers Dental Services, Hospital & Clinic Services
Taxonomy Code Requested on Claim Submissions – Portal Claims General, All Services
New - Provider Portal Remit Report for Manual Invoices and Recoupments, CR 101792 General, All Services
Rate Determination Initiation Notice for Sections 14, 30, 31, 45, 90, & 103: Certain Medicare Covered Family Planning Services and Long-Acting Reversible Contraception (LARCs) Hospital & Clinic Services
MaineCare Provider Enrollment Progress Update General, All Services
Section 93, Opioid Health Home Services (OHH), Cost of Living Adjustment (COLA) - CR 125032 Behavioral Health (BH)
Provider Training Survey Reminder General, All Services
Maine Clinician Survey on Hepatitis C Treatment Primary Care and Care Coordination
Submitting Electronic Transactions through Change Healthcare/Optum Clearinghouse Hospital & Clinic Services
Reducing Stillbirths in Maine: Free Count the Kicks Educational Materials and Webinars Behavioral Health (BH), Hospital & Clinic Services, Not in use
Appropriate Submission of Authorization to Release Information Forms General, All Services
Quarterly Physician Drug Codes Update: QTR 2 Hospital & Clinic Services
Section 23, Developmental and Behavioral Clinic Services: Child Abuse Evaluations, Draft Rate Model and Comment Deadline Behavioral Health (BH)
Rate Determination Initiation Notice and Public Forum Invite for Section 23, Developmental and Behavioral Clinic Services: Child Abuse Evaluations Behavioral Health (BH)
Section 17, Assertive Community Treatment (ACT) Services Staff Requirements Behavioral Health (BH)
Dental Surgeries Performed in Ambulatory Surgical Centers (ASC) CR 124455 Dental Services, Hospital & Clinic Services
REVISED Section 4, Ambulatory Surgical Center (ASC) Rates, Effective March 9, 2024, CR 124455 Hospital & Clinic Services
Apply to Present at the 2024 MaineCare Delivery System Reform Forums Behavioral Health (BH), General, All Services, Hospital & Clinic Services, Long Term Services and Supports, Not in use, Primary Care and Care Coordination
New Health Home Model for Substance Use Disorders (SUDs) –Rate Study Kickoff Meeting: Presented Materials Behavioral Health (BH)
Section 45, Hospital Inpatient Psychiatric and Substance Use Disorder (SUD) Unit Services – Rate Determination Comment Summary with Department Response Hospital & Clinic Services
MaineCare Provider Training Opportunities and Survey General, All Services
Webinar: What Primary Care Providers Need to Know About HIV General, All Services
UPDATE - Claims Pending for Missing Vendor Code​ General, All Services
Attention Pharmacy Providers: Updated Technical Instructions for Processing Backlogged Claims​ Retail Pharmacies
​Utilizing the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program for Children and Youth​ General, All Services
EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) App Long Term Services and Supports
UPDATE - Claims Pending for Missing Vendor Code​ General, All Services
MaineCare in Education: New Resources and Updated MaineCare in Education 2024 Guide School Health Related Services
Update: Crown Prior Authorization (PA) Exception for Endodontic Therapy Dental Services
UPDATE May 3, 2024 - Claims Pending for Missing Vendor Code General, All Services
Attention Section 90, Physician Service Providers: REVISED Calendar Year 2024 (CY24) Medicare Standardization Rates, CR 124074 Hospital & Clinic Services, Primary Care and Care Coordination
Quarterly Physician Drug Codes Update: QTR 1, CR 122400 Hospital & Clinic Services, Primary Care and Care Coordination
​Public Forum Postponed: Section 45, Hospital Service Providers Draft Reimbursement Methodologies​​ Hospital & Clinic Services
Claims Pending for Missing Vendor Code​ General, All Services
MaineCare Notice of Agency Major Substantive Rulemaking Adoption, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Not in use, State & Federal Policy
Electronic Visit Verification (EVV) Online Training Available Long Term Services and Supports