• Read more about 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).

• Read more about Maine CDC Announces Another Four Measles Cases; No New Exposure Locations Identified

AUGUSTA-- The Maine Department of Health and Human Services' Center for Disease Control and Prevention (Maine CDC) is announcing that four additional cases of measles have been confirmed in Maine. That brings the current total number of lab-confirmed cases in Maine to five, though there are no new exposure locations associated with these diagnoses and no new exposure risks for the public.

• Read more about Sections 68 & 85: 2026 Rates Implemented, CRs 137772 & 137770

Effective January 1, 2026, MaineCare updated reimbursement rates for Sections 68 and 85. These new rates reflect 72.4% of the current Maine Medicare rates.  

Initially, the Department uploaded an incorrect fee schedule for both section 68 and 85. Corrected fee schedules are now available on the Rate Setting page of the Health PAS Online Portal.  

• Read more about Section 43, Hospice Services: Kickoff & Draft Rates Forum, Presented Materials and Comment Deadline

On February 12, 2026, the Office of MaineCare Services (OMS) held a virtual public kickoff meeting for interested parties of hospice services. At this meeting, MaineCare reviewed project goals, a timeline for the *rate determination process, and presented draft rates with rationale and policy revisions under consideration for public comment.

• Read more about Hospital Days Awaiting Placement (DAP) Budget Reached for State Fiscal Year (SFY) 2025

Pursuant to MaineCare Benefits Manual (MBM), Chapter III, Section 45, the annual maximum amount per SFY that the Department will reimburse in-state acute and critical access hospitals for DAP claims is capped at $1,500,000 (see MBM section 45.02-8). The cap has now been reached for SFY 2025 (July 1, 2024, through June 30, 2025) and no additional payments will be made for DAP claims with Dates of Service (DOS) from July 1, 2024, through June 30, 2025.

• Read more about SNAP Rule #241 - Noncitizen Updates

10-144 C.M.R. Chapter 301; Supplemental Nutrition Assistance Program (SNAP) Rules;

Sections 111-2 and 444-4

SNAP Rule #241P - Noncitizen Updates

• Read more about Section 71, National Diabetes Prevention Program (NDPP) 2026 Rate Update

Effective January 1, 2026, MaineCare updated the NDPP reimbursement rate. This new rate reflects 100% of the current year Medicare rates. An updated fee schedule is available on the Rate Setting page of the Health PAS Online Portal.

• Read more about February Nursing Facility Training Events

Please join the Maine Pre-Admission Screening and Resident Review (PASRR) team for one of two upcoming Nursing Facility Provider training events in February.

These informative two-hour sessions will provide a refresher training on PASRR, AssessmentPro, PathTracker, and ServiceMatters. Additionally, there will be plenty of time available for Q&A with our program team.

Identical content will be shared during each session, so use the links below to register for the date and time that best fits your schedule.

• Read more about February Hospital Training Events

Please join the Maine Pre-Admission Screening and Resident Review (PASRR) team for one of two upcoming Hospital Provider training events taking place in February.

These informative two-hour sessions will provide a refresher training on PASRR, AssessmentPro, PathTracker, and ServiceMatters. Additionally, there will be plenty of time available for Q&A with our program team.

Identical content will be shared in both sessions, so use the links below to register for the date and time that best fits your schedule.

• Read more about Reminder: VitalCare for Kids (EPSDT)

MaineCare’s VitalCare for Kids (EPSDT) program allows members under the age of 21 to receive medically necessary services that are not typically covered due to limits on the type, frequency, or duration of the service. The program is designed to ensure children and youth receive early detection and care, so health problems are prevented or diagnosed and treated as early as possible.