Attention Providers: Capping of MaineCare Payment Cycles – May 2026
On April 13, 2026, we announced that the Department will need to temporarily withhold certain MaineCare payments to some providers through the end of the state fiscal year (which ends June 30, 2026).
Beginning with the payment cycle that will run on May 13, 2026, through June 30, 2026, the Department will temporarily:
- Withhold no more than 30 percent of the normal levels of Critical Access Hospital (CAH) and private psychiatric hospital prospective interim payments (PIPs);
- Withhold payment for all high-dollar hospital claims, defined as those greater than $50,000;
- Withhold payment for multi-state and large health system chain pharmacies and out-of-state retail pharmacies (excluding pharmacies within 15 miles of the Maine border);
- Withhold payment for large chain and out-of-state durable medical equipment providers; and
- Withhold payment for out-of-state providers of hospital and ambulance services.
We anticipate releasing any temporarily withheld payments during the first two payment cycles in July.
As a reminder, consistent with state and federal requirements, providers may not bill, demand, or otherwise seek payment from MaineCare members (or their representatives) as a condition of providing a MaineCare covered service.