Residential Care Facility (PNMI Appendix C) Rate Letters

Section 97, Appendix C Residential Care Facility (RCF) letters for January 1, 2022 – June 30, 2022 are now available on the Health PAS Online Portal.

As had previously been communicated, these letters – which normally go out in late December – were delayed pending the addition of an add-on payment component to comply with Section AAAA-5 of the FY22-FY23 biennial budget’s (PL 2021 Chap. 398) requirement that the Department increase rates to enable providers to cover labor costs for essential support workers, as defined in the Maine Revised Statutes, Title 22, section 7401, subsection 3, to equal at least 125% of the minimum wage. This add-on to the rate will be effective through June 30, 2022.

The letters also include another add-on payment component per an initiative in the Governor’s proposed FY22-FY23 supplemental budget to reinstate Supplemental Wage Allowances, which had been included in letters for FY19-FY21, but which had expired June 30, 2021. This add-on to the rate is also through June 30, 2022.

The Department is seeking CMS authority for these add-on components. 

You can access your rate letter by logging into your Trading Partner Account on the Health PAS Online Portal and following this pathway: File Exchange > Reports > Rate Setting Letters. The updated RCF rates will be in the system and available to bill mid next week. We will notify you through another e-message when the rates are available and provide instructions for claims adjustments.

If you have questions about accessing the letters, please contact Provider Services at: 1-866-690-5585. If you have questions about the content of the letters, please contact Rate Setting directly by using the contact name and phone number on the letters.

Note that the Department is currently calculating the facility-specific PNMI C rate adjustments needed to support rates that continue the 125 percent of minimum wage provision in fiscal year 2023 and beyond, as called for in Part AAAA of the biennium budget, which will be effective July 1, 2022.

See yesterday’s Maine DHHS press release highlighting this and additional supports provided to Maine Residential Care Facilities during the COVID-19 pandemic.

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