MaineCare Bulletins

Date Title Topic
Fiscal Year (​FY)24 Hospice Rate Update, October 1, 2023​ Long Term Services and Supports
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Section 1915(c) Waiver Appendix K Updates​ General, All Services
COVID-19 Vaccines for Fall 2023 Claim Submission Update General, All Services
​COVID-19 Vaccines for Fall 2023​ Claim Submission Update General, All Services
​Attention Section 67, Nursing Facilities (NFs): Extension of Extraordinary Circumstance Allowance (ECA) Application Deadline Long Term Care Services
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter II, Section 60, Medical Supplies and Durable Medical Equipment Not in use, State & Federal Policy
Attention Primary Care Plus (PCPlus) Providers: Reminder - PCPlus Open Office Hour Primary Care and Care Coordination
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Use of Nirsevimab and Palivizumab to Prevent Hospitalizations from Severe Respiratory Syncytial Virus (RSV) in High Risk Infants​ Hospital & Clinic Services, Primary Care and Care Coordination
Clubhouse Services Staff Requirements Behavioral Health (BH)
Training Opportunity Available for Family and Caregivers of Adults Receiving Services Within Section 12, 19, and 96 Programs Long Term Services and Supports
Attention Licensed Substance Use Disorder (SUD) Providers Behavioral Health (BH)
Attention Section 25, Dental Service Providers: Rate Determination Kickoff Meeting Dental Services
Opportunity Available for Section 19 Home and Community Based Services for Older and Disabled Adult Caregivers Long Term Services and Supports
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
​COVID-19 Vaccine Updates for Fall 2023 General, All Services
End of Section 1915(c) Waiver Appendix K Flexibilities General, All Services, General Notifications for All Providers
Respiratory Syncytial Virus (RSV) Educational Infographics Available Hospital & Clinic Services, Long Term Care Services, Primary Care and Care Coordination, Retail Pharmacies
​Durable Medical Equipment (DME) Prior Authorization (PA) Criteria Sheets Updated​, CR 119839 Specialty Services
Attention Section 43 Hospice Providers: Electronic Visit Verification (EVV): Implementation January 1, 2024 Long Term Services and Supports
Vendor Activation Form, CR 118819 General, All Services
Primary Care Plus (PCPlus) Performance-Based Adjustment (PBA) Update Primary Care and Care Coordination
Attention Section 30, Family Planning Agency Services, Alternate Payment Model (APM): Draft Rate and Service Model Public Review and Comment General, All Services, Hospital & Clinic Services
Blood Glucose Test Strip Dosing Limit with Continuous Glucose Monitors (CGM) Hospital & Clinic Services, Primary Care and Care Coordination, Retail Pharmacies
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Section 1915(c) Waiver Appendix K Updates​ General, All Services
Rate Determination Initiation Notice for a New Service Model Under Review for Future Proposal as MaineCare Benefits Manual (MBM), Section TBD: Palliative Care Interdisciplinary Team Services General, All Services, Long Term Care Services, Long Term Services and Supports, Primary Care and Care Coordination
Attention MaineCare Providers: Processing Delays for Enrollment and Revalidation General, All Services
MaineCare Rate Reform Expert Technical Advisory Panel (TAP) Consultation on Draft CY2024 Rate Determination Schedule: Presented Materials and Proposed Schedule General, All Services
Attention MaineCare Section 67, Nursing Facilities (NFs):  Extraordinary Circumstance Allowance (ECA) Application Guidance and Submission Deadline October 27, 2023  Long Term Care Services
Rate Determination Initiation Notice for Section 25, Dental Service Providers: Rebasing of Dental Benchmarks  Dental Services
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
MaineCare Guidance for Out-of-State Births General, All Services
Attention Providers of Section 67 Nursing Facilities (NF): Optional State Assessment (OSA) and Federal Minimum Data Set (MDS) Assessments Required Long Term Care Services
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Revalidate with MaineCare to Avoid Claim Denials General, All Services
​​COVID-19 Vaccine Updates for Fall 2023​ General, All Services
New Hyaluronic Acid Derivatives Criteria Sheet, CR 119147 General, All Services
​UPDATED Billing Guidance and Claims Reimbursement for Distinct Psychiatric and Substance Use Disorder (SUD) Units Hospital & Clinic Services
​Non-Emergent, Emergency Department (ED) Pricing Failure, TR 113880 Hospital & Clinic Services
​ ​Public Forum Postponed: Attention Section 97, Private Non-Medical Institutions (PNMI), Appendix D, Therapeutic Foster Care (TFC) Services: Draft Rate Model Public Review and Comment​ Behavioral Health (BH)
Certified Community Behavioral Health Clinics (CCBHC), Section To Be Determined: Kickoff Meeting Presented Materials Behavioral Health (BH)
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Attention Providers of Section 18, 20, 21, 29, Home & Community Based Supports for Individuals with Intellectual Developmental Disabilities and Proposed Lifespan Waiver: Amendment to Initiation and Section 21 & 29 Kickoff Meeting Presented Materials Long Term Services and Supports
New Place of Service (POS) Code 27: Outreach Site/Street General, All Services
Outpatient Hospital Claims Overpaid Under Ambulatory Payment Classification (APC), CR 119887  Hospital & Clinic Services
Over the Counter (OTC) Naloxone Standing Order for MaineCare Members Retail Pharmacies
Maine Center for Disease Control and Prevention Respiratory Syncytial Virus (RSV) Products Webinar Hospital & Clinic Services, Long Term Care Services, Primary Care and Care Coordination
Rights of Recipients of Mental Health Services and Rights of Recipients of Mental Health Services Who Are Children in Need of Treatment Behavioral Health (BH)