Training Opportunity Available for Family and Caregivers of Adults Receiving Services Within Section 12, 19, and 96 Programs

The Office of Aging and Disability Services is excited to announce a virtual Mental Health training series opportunity scheduled for Monday, July 8, 2024, Thursday, July 11, 2024, and Monday, July 15, 2024. This training is being provided under collaboration with the National Alliance on Mental Illness (NAMI) Maine and is available for caregivers providing care to Section 12, 19, and 96 members. Caregivers can include personal support staff, attendants, home health aides, nurses or other natural and family supports.

Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840

This is a reminder that the attending provider is required on all UB-04 and 837I claims. MaineCare denies UB-04 and 837I claims submitted without an enrolled attending provider.

The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment reported in the claim/encounter. The attending provider requirement includes all claim submission methods (paper, HealthPAS Online Portal, or 837I).

10-144 C.M.R. Ch. 331; Public Assistance Manual Temporary Assistance for Needy Families (TANF); TANF Rule #118 Adoption

The adopted rule clarifies program requirements in Chapters I, II, IV and V for applicants and the Department as they relate to non-citizen eligibility. These requirements are consistent with 42 U.S.C. § 602 and 45 C.F.R. § 260. Asset limit changes in Chapter III are consistent with P.L. 2023 Ch. 366, An Act to Allow Maine Families to Increase Their Savings by Changing the Asset Limits for Eligibility for the Temporary Assistance for Needy Families Program.

Updated Guidance for Power Mobility Devices (PMD), CR 124323

Medicare has updated the documentation guidelines on PMDs, which include Power Operated Vehicles (POV) and Power Operated Wheelchairs (POW). Until such a time as the MaineCare Benefits Manual (MBM), Section 60.08-8(C) is updated, the Prior Authorization (PA) department will review PA requests consistent with the updated requirements that will also be included in the PA criteria sheet located on the Health PAS online portal. Updated PA criteria includes:

Rate Determination Initiation Notice for Home and Community Based Services (HCBS) Clinical, Therapy, Care Coordination, Supportive Skills Building, and Assistive Technology Services

This bulletin provides notice that the Department has initiated a Rate Determination Process* for certain HCBS services found in MaineCare Benefits Manual (MBM) Sections 12, 18, 19, 20, 21, 29, 40, 96, and 102 and is now conducting a rate study. Public Consulting Group will be conducting this rate study. MaineCare will provide a list of service categories to be reviewed once the Department's contracted vendor performs a code analysis of the sections.  

EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) App

EVV Providers who are currently using the SMC app through their phone, tablet, or other mobile device should update to the latest version of the app using the Apple Store, or Google Play. The current version of the app is being phased out as of July 1, 2024. To avoid any interruption of visit record keeping, you should now download the latest version of the app. 

Please contact Provider Services with questions:  

  • 1-866-690-5585, option 3.

MaineCare Cost of Living Adjustments (COLAs) Effective July 1, 2024

MaineCare is increasing reimbursement rates for certain services in the policy sections listed below, through a COLA as directed by MRS Title 22, §3173-J (referred to as ‘Rate Reform Statute’). The COLA will be effective July 1, 2024, and is equal to an increase of 2.54% above the currently established rate(s). This COLA increase is proportional to the percentage increase in the Maine minimum wage as determined by the Maine Department of Labor.

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