Attention Pharmacy Providers: Confirmed Initial Restoration of Maine Point of Purchase System (MEPOPS) on March 27, 2024

Mar 27, 2024

MaineCare successfully initiated the first phase of restoration of MEPOPS today, March 27, 2024. This follows the disruption that occurred on February 21, 2024, due to the national cyber security issue affecting Change Healthcare. For more information about the Department’s response to this outage and resources available to pharmacies, please see this pharmacy provider FAQ.  

We will continue to notify pharmacies of milestones as the phased restoration progresses, such as when we reinstate prior authorizations, until we can confirm that the system is fully operational. Please refer to our previous e-message for more information supporting the decision to restore the system at this time.

Beginning today, March 27, 2024, pharmacies may transmit claims with dates of service during the outage period (February 21 through March 26) and may also transmit claims ongoing. As stated in its February 27, 2024 message, MaineCare will pay all eligible claims submitted during the outage. Pharmacies will resume receiving payments by the end of the second week of April, upon successful integration of the claims payment file from Change Healthcare to MaineCare’s fiscal agent responsible for issuing claims payments. Maine-based pharmacies will receive another interim payment the first week of April to continue support until the claims payments are available. For Maine-based pharmacies, claims payments will reconcile against interim payments. For Maine health system-based pharmacies, 100% of claims payments will be offset until interim payments are recouped; for independent and safety net pharmacies, 75% of claims payments will be offset until interim payments are recouped. See previous e-messages here and here for lists of pharmacies receiving interim payments. 

The Department stands ready to assist pharmacies as we continue to transition MEPOPS back into service. Please see our previous e-message for details on continued waived requirements and supports available during this transition, including technical instructions and Optum’s Change Healthcare Pharmacy Provider Help Desk, which pharmacies can contact at 1-888-420-9711.

MaineCare Pharmacy Service Disruption Office Hours – Thursday March 28, 2024 

For additional support, MaineCare is inviting you to join the next Office Hours call with the MaineCare Pharmacy team on Thursday, March 28, 2024, from 11 a.m. – 11:45 a.m. related to the current service disruption. We will use this time as an opportunity for sharing questions and concerns and providing technical support from the State. Please register in advance for this meeting: https://mainestate.zoom.us/meeting/register/tZMuduuhrzguG9cvWTFKS3oNy_uVNAY_iB47 

As there are developments related to the system restoration, we will send updated communications.