MaineCare Bulletins

Date Title Topic
MaineCare Benefits Manual Section 97, Appendix D Children’s Residential Care Facility (CRCF) Services: Changes to Kepro Referrals and Prior Authorizations (PA)  Behavioral Health (BH)
Community Health Worker (CHW) Webinar  Primary Care and Care Coordination
Community Health Worker (CHW) Webinar  Behavioral Health (BH)
Attention Dental Providers: Dental Rate Forum Dental Services
Reminder for Providers Billing on UB-04 and 837I Claims, CR 107682  General, All Services
Certified Community Behavioral Health Clinic (CCBHC) Initiative Not in use
Certified Community Behavioral Health Clinic (CCBHC) Initiative Behavioral Health (BH)
Clarification Regarding Charging Recipients for COVID-19 Vaccinations General, All Services
Provider Enrollment Application (PEA) Outage General, All Services
System Maintenance from April 23, 2022 to April 24, 2022     General, All Services
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
Pharmacy Point of Sale (POS) Blackout Period April 20, 2022 Retail Pharmacies
Primary Care Plus (PCPlus) Year One Final Application Period Now Open   Not in use
Primary Care Plus (PCPlus) Year One Final Application Period Now Open   Primary Care and Care Coordination
2022 Rate Updates for Medical Imaging Codes, CR 107225  General, All Services
Dental Problems with Buprenorphine Dissolved in The Mouth to Treat Opioid Use Disorder (OUD) and Pain Behavioral Health (BH)
Dental Problems with Buprenorphine Dissolved in The Mouth to Treat Opioid Use Disorder (OUD) and Pain Primary Care and Care Coordination
Dental Problems with Buprenorphine Dissolved in The Mouth to Treat Opioid Use Disorder (OUD) and Pain Hospital & Clinic Services
Dental Problems with Buprenorphine Dissolved in The Mouth to Treat Opioid Use Disorder (OUD) and Pain Dental Services
No Prior Authorization (PA) Needed for Insulin Used During Pregnancy Retail Pharmacies
No Prior Authorization (PA) Needed for Insulin Used During Pregnancy  Hospital & Clinic Services
No Prior Authorization (PA) Needed for Insulin Used During Pregnancy Primary Care and Care Coordination
Electronic Visit Verification (EVV) Frequently Asked Questions (FAQs) Long Term Services and Supports
Electronic Visit Verification (EVV) Frequently Asked Questions (FAQs) Not in use
Rate Updates General, All Services
System Maintenance from April 9, 2022 to April 10, 2022    General, All Services
MaineCare Updated COVID-19 Vaccine Administration Rate, CR 107185  General, All Services
Microdyn Updates for Ambulatory Payment Classifications (APC), CRs 107154 & 107155  Hospital & Clinic Services
The Impact of Bias and Microaggressions Webinar Behavioral Health (BH)
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
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)
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
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
MaineCare Job Openings General, All Services
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
Attention Durable Medical Equipment (DME) Providers: New Rates for Ostomy Equipment and Supplies Specialty Services
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
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
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
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
Reimbursement for COVID-19 Testing, Treatment, and Vaccination Services for Uninsured Individuals  General, All Services
Integrating Care for Perinatal Populations with Opioid Use Disorder Online Webinar Hospital & Clinic Services
Integrating Care for Perinatal Populations with Opioid Use Disorder Online Webinar Behavioral Health (BH)
Integrating Care for Perinatal Populations with Opioid Use Disorder Online Webinar  Not in use
Claim Denials for No Attending Provider on UB-04 and 837I Claims, CR 107682 General, All Services
Notice of Agency Rule-making Proposal: Chapter 101, MaineCare Benefits Manual, Chapters II & III, Section 93, Opioid Health Home Services State & Federal Policy
Ambulance Services Reimbursement and Locality Modifiers, CR 108340  Hospital, Family Planning, and Ambulatory Care/Clinic Services
Ambulance Services Reimbursement and Locality Modifiers, CR 108340  Specialty Services
Payments to Home and Community-Based Services (HCBS) Providers Long Term Care Services
Payments to Home and Community-Based Services (HCBS) Providers School Health Related Services