See the MaineCare COVID-19 webpage for updates on the Coronavirus.
MaineCare Audit Cost Reports Extension
Providers with a December 31, 2019 fiscal year end date are ordinarily required to submit their cost reports within five months of their fiscal year end, by May 31, 2020. However, in light of CMS’ extension for Medicare providers to file cost reports in response to the nation pandemic, the Department will apply the same extension to MaineCare cost reports. We will accept December 31, 2019 cost reports with postmarked dates through July 31, 2020.
KEPRO's Referral Management Process: Family Choice Members
Attention Reffering Providers: Effective May 11, 2020, the Office of Children and Family Services (OCFS), in coordination with KEPRO, has implemented changes in the referral management process to improve the referral process for both Home and Community Treatment and Rehabilitative Community Services. Please see the OCFS KEPRO Family Choice (PDF) for details.
Code and Rate Updates
See the Code and Rate Updates webpage for spreadsheets of affected codes and rates.
- 2019 August Attestation PCP Increase (PDF)
- Please contact Tia Bolduc, Provider Relations Specialist, with questions at (207) 624-6938.
False Claims Act/ Fraud Abuse
- Department of Justice Summary
- False Claims Act Checklist
- Providers Who Receive $5.0 Million or More Per Year
- De-Identification Methods (CMS webpage) - Explanation of identifiable health information and how to de-identify materials.
- Educational Materials about HIPAA Security (CMS webpage)
- Secure Fax and E-mail
Manuals, Guides, and Instructions
- Billing Instructions (Health PAS Online Portal)
- Case Mix Manuals
- Companion Guides (Health PAS Online Portal)
- Home Health Instructions
- MaineCare Benefits Manual
- MyHealth PAS User Guides (Health PAS Online Portal)
- Preadmission Screening and Resident Review (PASRR) Manual
- Private Duty Nursing (PDN) Instructions
- Trading Partner Guides (Health PAS Online Portal)
- X.12 HIPAA Acknowledgements (Health PAS Online Portal)
- Healthcare Provider Taxonomy Code Set
- National Plan and Provider Enumeration System (NPPES) Home Page
- NPI Application Help Page
- DXC Provider Services can help you with claims and billing questions or concerns. Contact us at 1-866-690-5585. TTY users dial 711. You can also e-mail.
- MaineCare Provider Relations can help with policy-related questions or concerns. Please see the Provider Relations Assignment List (PDF) which lists the Provider Relations Specialists by section of policy.