MaineCare Bulletins

Date Title Topic
Attention Pharmacy Providers: 30-Day Prescriptions Authorized in Response to Change Healthcare Network Outage Retail Pharmacies
Attention Providers: UPDATE on Issues Processing MaineCare Pharmacy Claims General, All Services
Attention Providers: Possible Delays in Prior Authorizations Due to Network Interruption General, All Services
Sections 68, Physical Therapy and 85, Occupational Therapy Providers: Medicare Standardization Rates Implemented for Calendar Year 2024 (CY24) CR 122976 Specialty Services
Attention Section 67, Nursing Facilities (NFs): Draft Rate Methodology Public Review and Comment Long Term Care Services
Attention Providers: Network Interruption Resulting in Issues Processing MaineCare Pharmacy Claims General, All Services
Attention Pharmacy Providers: Handling of MaineCare Claims During Change Healthcare Network Outage Retail Pharmacies
Attention Pharmacy Providers: Network Interruption Retail Pharmacies
Microdyn Update for Ambulatory Payment Classifications (APCs) CRs 122405 & 122406 Hospital & Clinic Services
Attention Section(s) 18, 21, and 29 Providers: Updated Section 1915(c) Waiver Appendix K Flexibility Guidance General, All Services
​​Over the Counter (OTC) Naloxone Standing Order for MaineCare Members​ Retail Pharmacies
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
What’s Happening with Housing Webinar: 11:30 AM, Thursday, March 7, 2024 General, All Services
Provider Survey- Attitudes Towards Contingency Management (CM) for Treatment of Substance Use Disorder (SUD) Behavioral Health (BH)
Training Opportunity Available for Section 19 Home and Community Based Services for Older and Disabled Adult Caregivers Long Term Services and Supports
Attention Section 90, Enhanced Primary Care Providers: REVISED Calendar Year 2023 (CY23) Rates - CR 116094 Primary Care and Care Coordination
Section 30, Family Planning, Implementation of Base Rate and Resulting Final Rate, CR 122825 Hospital & Clinic Services
Correction: Taxonomy Code Requested on Claim Submissions – Portal Claims General, All Services
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Provider Enrollment Presentation Follow-Up and Progress Update General, All Services
Taxonomy Code Requested on Claim Submissions General, All Services
Section 101, Medical Imaging Services: Medicare Standardization Rates Implemented for Calendar Year 2024 (CY24) CR 122712 ​ Specialty Services
​Updated Billing Guidance for the Alternate Payment Methodology (APM) for Federally Qualified Health Centers (FQHC) Primary Care and Care Coordination
​Updated January 1, 2023 Behavioral Health Rate Adjustments FAQs Regarding Assertive Community Treatment (ACT) Behavioral Health (BH)
​Primary Care Plus (PCPlus) and Community Health Worker Overview Webinar​ General, All Services, Primary Care and Care Coordination
​Standing Order for Dispensing COVID-19 At Home Tests to MaineCare Beneficiaries Retail Pharmacies
Section 45, Hospital Service Providers: Public Forum Draft Reimbursement Methods Hospital & Clinic Services
​Attention Section 50, Intermediate Care Facilities: Reprocessing of Day Habilitation Claims - CR 122772               Long Term Care Services
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Provider Responsibility for Managing Users in My HealthPAS Trading Partner Accounts (TPA) General, All Services
Attention Providers: Survey Available on the Correlation Between Alcohol and Cancer General, All Services
Update: ​Targeted Case Management (TCM) Services Provided by Indian Health Services (IHS)​ Primary Care and Care Coordination
EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) App Long Term Services and Supports
Provider Enrollment National Provider Identifier (NPI) Entry Enhancement, CR 122156 General, All Services
Sections 15, 75, 109 and 95, Calendar Year 2024 (CY24) Medicare Standardization Rates Implemented, CRs 122519, 122524, 122526 General, All Services
MaineCare Notice of Agency Rule-making Proposal, Chapters II and III, Section 23, Developmental and Behavioral Health Clinic Services Not in use, State & Federal Policy
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
340B Program Overview General, All Services
Targeted Case Management (TCM) Services Provided by Section 9, Indian Health Services (IHS) Primary Care and Care Coordination
Training Opportunity Available for Section 19 Home and Community Based Services for Older and Disabled Adult Caregivers Long Term Services and Supports
Reminder: Home and Community Based Services (HCBS) Compliance Form Instructions for Waiver Services Provider General, All Services
The American Society of Addiction Medicine (ASAM) 4th Edition Release Behavioral Health (BH)
Attention Section 14, Advanced Practice Registered Nursing (APRN) and Section 90, Physician Services: 2024 Anesthesiology Rate Updates, CR 122923 Hospital & Clinic Services, Primary Care and Care Coordination
Issue Corrected: Attention Section 67 Providers – Members Coverage Inadvertently End-Dated in MIHMS Long Term Care Services
Updated January 1, 2023, Behavioral Health Rate Adjustments FAQs Regarding Assertive Community Treatment (ACT) Behavioral Health (BH)
Attention Providers: New Ways to Connect Your Patients to Mental Health Care General, All Services
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
​​Comment Deadline Extended: Mobile Crisis Response Teams, Draft Service Model and Rates​ Behavioral Health (BH)
Provider Enrollment Presentation Session Materials​ General, All Services
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual Chapter II, Section 29 Not in use, State & Federal Policy