Update*: MaineCare Cost of Living/ “Part AAAA” Adjustments

Mar 05, 2024

MaineCare increased reimbursement rates for certain services through a cost-of-living adjustment (COLA) as directed by 22 MRSA Section 3173-J and 22 MRSA Section 7402, as enacted by Maine P.L. 2021, ch. 398, Part AAAA. The COLA is effective as of January 1, 2024, and is equal to an increase of 2.54% above the currently established rate(s). As directed by Maine P.L. 2021, ch. 398, Part AAAA, this increase is equal to the increase in the state minimum wage from January 1, 2023, to January 1, 2024, as established in 26 MRSA Section 664, Subsection 1. Part AAAA requires this increase with the objective to ensure that the labor components of rates for these services continue to equal at least 125% of Maine minimum wage.

Note: these COLA adjustments only apply to rates specified under these Sections of Policy for eligible services: when a Section of Policy cross-references rates in a separate Section of Policy, the reimbursement provisions in the cross-referenced section of policy dictates the reimbursement amount (e.g. services that are driven by reimbursement under Section 90, will not receive this COLA).

These COLAs affect rates for eligible services under the following Sections of the MaineCare Benefits Manual (MBM):

 

COLA Rate Adjustments: MaineCare Benefits Manual Sections and Services
Section 2*	Adult Family Care Services
Section 12	Consumer Directed Attendant
Section 13*	Targeted Case Management Services
Section 17*	Community Support Services
Section 18	HCBS for Adults with Brain Injury
Section 19	HCBS for the Elderly and Adults with Disabilities
Section 20	HCBS for Adults with Other Related Conditions
Section 21	HCBS for Members with Intellectual Disabilities or Autism Spectrum Disorder
Section 26*	Day Health Services
Section 28*	Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations
Section 29	Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
Section 65*	Behavioral Health Services
Section 92*	Behavioral Health Home Services
Section 96	Private Duty Nursing and Personal Care Services

*pending approval of appropriations.

The Department will post the updated fee schedules for the Sections above to the Rate Setting page of the MaineCare Health PAS portal as they are completed. Billing guidance and Prior Authorization (PA) details will be forthcoming. 

*Update: There is a supplemental budget initiative in progress to support future approval of appropriations. 

Please contact Amanda Lee, Rate Setting Coordinator with questions.