MaineCare Bulletins

Date Title Topic
MaineCare Notice of Agency Waiver Amendment, MaineCare Benefits Manual, Section 18, Home and Community Based Services for Members with Brain Injury Not in use, State & Federal Policy
MaineCare Notice of Agency Waiver Amendment, MaineCare Benefits Manual, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder  Not in use, State & Federal Policy
MaineCare Notice of Agency Waiver Amendment, MaineCare Benefits Manual, Section 20, Home and Community Based Services for Adults with Other Related Conditions Not in use, State & Federal Policy
Taxonomy Code Requested on Claim Submissions – Portal Claims General, All Services
Revalidate with MaineCare to Avoid Claim Denials General, All Services
Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840 General, All Services
New Dental Tools and Upcoming Dental Forum for Providers Dental Services
Attention HCBS Providers of Care Coordination Services for Sections 12, 19, and 96: Interested Parties Engagement Session Presented Materials Long Term Services and Supports
Service Provider Tax (SPT) Repeal: Affected Service Codes and Frequently Asked Questions (FAQ) General, All Services
Attention Section 90, Physician Service Providers: Seasonal Flu Codes and Rates Updated, CR 126775 Hospital & Clinic Services
Training Opportunity Available for Family and Caregivers of Adults Receiving Services Within Section 12, 19, and 96 Programs Long Term Services and Supports
Attention MaineCare Section 67, Nursing Facilities (NFs): Additional Extraordinary Circumstance Allowance (ECA) Payments Long Term Care Services
Attention HCBS Providers of Assistive Technology Devices and Services: Interested Parties Engagement Session Presented Materials Long Term Services and Supports
Help MaineCare Rebrand the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program General, All Services
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
Kickoff Meeting Presented Materials and Upcoming Provider Engagement Sessions for HCBS Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, Assistive Technology & Personal Support Services Long Term Services and Supports
EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) Application: Revised Phase Out Date Long Term Services and Supports
Electronic Visit Verification (EVV) Online Training Available Long Term Services and Supports
Registration is Open for the MaineCare 2024 Delivery System Reform (DSR) Forums General, All Services
Code & Service Category List: HCBS Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, Assistive Technology & Personal Care Services Long Term Services and Supports
Section 45, Hospital Diagnostic Related Group (DRG) and Ambulatory Payment Classification (APC) Reimbursement Changes Effective July 1, 2024 Hospital & Clinic Services
Post Incarceration Incentive Payment Pilot Update General, All Services, Not in use
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter III, Section 45, Principles of Reimbursement for Hospital Services Not in use, State & Federal Policy
HIV Testing Now Recommended Quarterly by Maine CDC General, All Services
Maine’s Children & Youth with Special Health Care Needs Webinar Learning Series: MaineCare in Education Behavioral Health (BH)
Attention Pharmacy Providers: Status of Restoration of Maine Point of Purchase System (MEPOPS) and Office Hours with MaineCare’s Pharmacy Team Retail Pharmacies
Text Messaging Not Accepted Method of Substantive Contact for Section 13, Targeted Case Management (TCM) Services Behavioral Health (BH)
Certified Community Behavioral Health Clinic (CCBHC) Certification Documentation Due September 6, 2024 Behavioral Health (BH), General, All Services, Not in use, Primary Care and Care Coordination
​Attention Section 65, Behavioral Health Services Providers: Temporary Claims Payment Delay General, All Services
Critical Access Hospitals (CAH) Swing Bed and Nursing Facility (NF) Days Awaiting Placement (DAP) Rate Updates, CR 125823 Hospital & Clinic Services, Long Term Care Services
Update Your MaineCare Enrollment with Accurate Information General, All Services
Virtual Forum for Dental Service Providers Dental Services
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program for Children and Youth – New Provider Resources Available General, All Services
MaineCare Notice of Agency Emergency Rule-making Adoption, Chapter III, Section 45, Principles of Reimbursement for Hospital Services Not in use, State & Federal Policy
EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) Application: Revised Phase Out Date Long Term Services and Supports
Section 45, Hospital Services Rate Reform Comment Summary with Department Response Hospital & Clinic Services
Attention Section 17, Community Support Service Providers: Updated Guidance Regarding Delay to January 1, 2024 COLA Implementation Behavioral Health (BH)
Attention Section 17, Community Support Service Providers: Implementation of January 1, 2024, COLA Delayed to August 14, 2024 Behavioral Health (BH)
Amendment to Initiation Notice: Sections 12, 18, 19, 20, 21, 29, 40, 96, & 102, HCBS Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, Assistive Technology Services, & Personal Support Services Long Term Services and Supports
CORRECTION: Implementation Date of Section 92, Behavioral Health Homes (BHH) Retroactive COLA, CR 125416 Behavioral Health (BH)
Rate Determination Kickoff Meeting: Sections 12, 18, 19, 20, 21, 29, 40, 96, & 102, Home & Community Based Services (HCBS) Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, & Assistive Technology Services Long Term Services and Supports
Health PAS Online Portal – New: Member Renewal Date Now Available, CR 119276 General, All Services
Skin Substitutes no Longer Require a Prior Authorization (PA) - CR 126315 Hospital & Clinic Services, Specialty Services
Attention MaineCare Providers: Notice of Returning Pharmacy Processes Including Prior Authorizations General, All Services
Attention Pharmacy Providers: Status of Restoration of Maine Point of Purchase System (MEPOPS) and Office Hours with MaineCare’s Pharmacy Team Retail Pharmacies
Sections 2, 13, 17, 26, 28, and 65: Implementation of Cost-of-Living Adjustments (COLAs) Effective January 1, 2024 Behavioral Health (BH), Long Term Care Services, Long Term Services and Supports
Section 92, Behavioral Health Homes (BHH): Implementation of Cost-of-Living Adjustments (COLAs) Effective December 21, 2023, CR 125416 Behavioral Health (BH)
Registration is Open for the MaineCare 2024 Delivery System Reform (DSR) Forums General, All Services
Electronic Visit Verification (EVV) Online Training Available Long Term Services and Supports
MaineCare Enrollment Opportunity: MaineCare Benefits Manual (MBM), Chapter II, Section 71: National Diabetes Prevention Program (NDPP) Services General, All Services, Hospital & Clinic Services, Primary Care and Care Coordination