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On May 7, 2024, MaineCare held a virtual public meeting with interested parties to present the major elements of the new SUD Health Home model and describe the process and timeline for this rate study. Participants had the opportunity to ask questions and provide feedback.
MaineCare’s Delivery System Reform (DSR) Annual Forums will be held on:
This year, MaineCare is turning the tables and wants to hear from YOU! Consider applying to be a presenter.
May 5, 2024
The Department of Health and Human Services (DHHS) continues to make progress on key priorities and efforts to implement the numerous laws and initiatives advanced by the 131st Legislature as it approaches adjournment.
Maine was in the news recently for leading the nation in diagnosing HIV at late stage. To help primary care providers learn about HIV and AIDS, MaineCare is hosting a webinar, What Primary Care Providers Need to Know About HIV, on May 9, 2024, at 11:30 AM. This 30-minute free webinar will be led by Dr.
Under Lambrew’s leadership, Maine expanded affordable health care to more than 100,000 people, led the nation in COVID-19 response, made historic investments in health and human services, and rebuilt the Department
Governor Janet Mills announced today that Jeanne Lambrew, Ph.D., will step down from her position as Commissioner of the Department of Health and Human Services, effective May 31, 2024, to accept a position leading national health policy development and to teach at Harvard University.
The Office of MaineCare Services (OMS), Office of the State Controller, and Gainwell have resolved the issues with claims going to a PEND status for a Missing Vendor Code (Edit 6037), that occurred twice last week.
Please note that Gainwell is mass adjudicating all the claims affected and there should be no impact on next week’s payment.
Pharmacy claims resumed processing on March 27, 2024. MaineCare continues to work with Optum to review outstanding rejected claims with dates of service during the system outage. The guidance below applies to claims with dates of service from February 21, 2024, through March 26, 2024.
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:
The goal of the EPSDT program is to ensure that individual children get the health care they need when they need it – the right care to the right child at the right time in the right setting.
MaineCare’s EPSDT program allows MaineCare members under the age of 21 to receive services that are not typically covered due to limits on the type, frequency, or duration of the service. These services can include preventive, dental, developmental, behavioral and/or mental health, and specialty services.
The Office of MaineCare Services (OMS) has become aware that after the issue was resolved regarding the Missing Vendor Code (Edit 6037) from the May 1, 2024 e-message, the same issue occurred during the overnight process on May 2, 2024. This issue is being investigated and addressed by multiple entities including: OMS, Gainwell Technologies, and the Office of the State Controller.