School Health-Related Services
This webpage provides information and important updates about policy and billing changes to MaineCare-covered services that are provided in an educational setting.
New MaineCare in Education Online Courses!
The Office of MaineCare Services is excited to share new resources where you can learn more about how MaineCare Covered Services are delivered in Maine schools. You can access all courses using a desktop, tablet, or mobile device.
Training Resources for School Administrators, MaineCare Providers, and Other Partners
School Administrators, MaineCare Providers, and Other Stakeholders, please be sure to take the courses in order, starting with MaineCare 100. At the end of each course, you will be asked to submit contact information to receive a certificate of completion for each course.
MaineCare 100: Introduction to MaineCare
This course presents an overview of the MaineCare program. Participants will learn about the purpose of the program, basic eligibility requirements, the application process, member responsibilities, and what resources are available for MaineCare members. This course takes about forty-five (45) minutes to complete.
MaineCare 101: Introduction to School Health-Related Services*
Sometimes students need to access health services in school settings. Since there are separate federal and state regulations and authorities providing guidance for Medicaid and education programs, it is critical to understand how the two systems work together to support students. This course provides foundational information to explain the basis for Medicaid reimbursement in school settings. Participants will learn about what covered services enrolled MaineCare providers can deliver in school settings, and how the services are accesed by student MaineCare members. This course takes about forty-five (45) minutes to complete.
*Prerequiste Required: Completion of MaineCare 100 Introduction to MaineCare.
MaineCare 102: Advanced School Health-Related Services for Providers*
MaineCare providers must ensure they understand the full scope of requirements related to delivery of MaineCare covered services. This course provides an opportunity for participants to expand on the information presented in MaineCare 100 and 101 related to the delivery of School Health-Related Services. This course takes about two (2) hours to complete.
*Prerequistes Required: Completion of MaineCare 100 Introduction to MaineCare and MaineCare 101 Introduction to School Health-Related Services.
MaineCare 103: Private Duty Nursing (PDN) Services*
Through this course participants will have the opportunity to gain a greater understanding of how Private Duty Nursing (PDN) services may be delivered in Maine schools. As with other School Health-Related services, schools have the option of delivering services directly, or contracting with an enrolled MaineCare provider.
*Prerequistes Required: Completion of MaineCare 100 Introduction to MaineCare, MaineCare 101 Introduction to School Health-Related Services, and MaineCare 102 Advanced School Health-Related Services for Providers.
MaineCare in Education 104 EPSDT for Children and Youth
The goal of the Early and Periodic Screening, Diagnostic, and Treatment Program (EPSDT) is to ensure that individual children get the right care to the right child at the right time in the right setting. Through this course participants will learn about the how EPSDT is accessed by children and youth.
MaineCare in Education 105 Navigating Seed
Tailored specifically for school administrators responsible for oversight of their School Administrative Unit’s MaineCare reimbursement, this course provides in-depth training on what Seed is, and how to access and review quarterly Seed reports.
MaineCare in Education 107: February 2024 Bootcamp
Through this course participants can view the presentation made specifically for school administrators. Presented in collaboration with the Maine Department of Education, this bootcamp provides an overview of reimbursement opportunities and clarifies some of the challenges schools have faced in delivering MaineCare-covered services to students.
Additional Resources for School Administrators and other Providers
- MaineCare Member Count by Zip Code (PDF) - This is a listing of the number of enrolled MaineCare members by zip code and age, updated quarterly. This resource will assist SAUs in planning for MaineCare reimbursement.
- Private Duty Nursing (PDN) Services FAQ - October 5, 2023
- Secondary Authorization Forms Required for Schools Providing PDN Services:
- Frequently Asked Question (FAQs) for School Health-Related Service Providers Related to OMS' Restraint Guidance - April 24, 2023.
- MaineCare in Education 2024 School Health-Related Services Billing Guide (PDF) - This guide is for anyone involved in the provision of Medicaid services.
MaineCare and Maine Department of Education Joint Training Resources
- Guidance on IEP Documentation (PDF) - May 2021
- MaineCare in Education Bootcamp - February 2024 Power Point Presentation (PDF)
- MaineCare in Education Bootcamp FAQ (PDF)
- Seed Dispute Form (PDF)
- Common School Health-Related Services and Descriptions April 2024 (PDF)
Development of a New School Health-Related Services Rule
The DHHS Office of MaineCare Services (OMS) is drafting a new section of the MaineCare Benefits Manual, Section 106, which will contain requirements for the provision of School Health-Related Services. School Health-Related Services are MaineCare-covered services, delivered in school settings, to MaineCare members by enrolled and qualified MaineCare providers.
Additional resources will be available here as MaineCare proceeds with the rulemaking process. MaineCare anticipates the rulemaking process will start after a rate study is completed.
Virtual Meetings and Trainings
All providers who deliver MaineCare services in schools are encouraged to sign up to be part of the "MaineCare in Education Sessions" team. You will receive information and resources about School Health Related Services through virtual meetings and training opportunities. Complete the online form to register.
Parent & Guardian Training
My Student and MaineCare
This online course was created with parents and guardians in mind. It provides an overview of what MaineCare is and how students can get MaineCare services in schools. This course takes about forty-five (45) minutes to complete.
Questions?
If you have questions, please email them to the MaineCare in Education. You may also email Trista Collins, State Medicaid Education Liaison.