(EPSDT) Shell Case Guidance for Behavioral Health Providers
This notice includes guidance from Acentra Health in partnership with the Office of MaineCare Services (OMS), on the use of shell cases in Atrezzo.
Elimination of Mailing Paper Remittance Advice (RA) and Reduction of Paper Checks, CR 132320
Paper RAs
This fall, the Office of MaineCare Services (OMS) will eliminate the mailing of all paper RAs to providers. This is a cost-saving initiative for the Department. We encourage those who receive paper RAs to reference the electronic PDF versions posted on the Health PAS Online Portal. Advantages of using the PDF version include easier member and claim searching and access to previous RAs.
Apply to Present at MaineCare’s Delivery System Reform (DSR) Annual Forum
Presenters needed for the Forum Dates & Locations:
- Wednesday, November 5, 2025, in Presque Isle, ME
- Thursday, November 13, 2025, in Brewer, ME
- Tuesday, November 18, 2025, in Portland, ME
MaineCare is once again inviting you to submit presentation proposals this year!
Billing Reminder: When Services are Rendered Via Telehealth
All MaineCare services delivered via Telehealth must comply with Ch I, Section 4 of the MaineCare Benefits Manual (MBM). Unless otherwise specified, all services must be billed in accordance with applicable sections of the MBM. Providers must also submit claims in accordance with Department billing instructions.
Provider Billing Requirements in Chapter I, Section 1: General Administrative Policies and Procedures - Reminder
Providers who are enrolled with MaineCare may not request payment from MaineCare members for covered services.
Maine DHHS: Recognizing the Second Annual 988 Day of Action
Sep 9, 2025
"Compassionate Help. Anytime.
Microdyn Update for Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) – CRs 133841, 133842, 133900
Effective August 23, 2025, we completed the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates in MIHMS. The following CMS documents provide the details of the APC and DRG updates:
July 2025 Integrated Outpatient Code Editor Specs
July 2025 Update of Hospital Outpatient Prospective Payment System (OPPS)
Section 67, Nursing Facility (NF) Reform – Phase II Specialty Care Draft Rate Model Presented Materials and Comment Deadline
On September 3, 2025, MaineCare held an online public meeting to present the recommended draft rates and rate models in addition to rationale for NF Specialty Units under Section 67 of the MaineCare Benefits Manual.
10-144 CMR Ch 108 Home and Community Support Services Agency Licensing Rule EMERGENCY RULE
This emergency rulemaking operationalizes the statutory requirements of 34-B M.R.S. § 1203-B, Licenses for agencies that provide services to adults with certain conditions. Under this statute, any agency that provides a service, if that service is funded in whole or in part by the Department, to an adult with an intellectual disability, autism spectrum disorder, a related condition or an acquired brain injury, including a service provided under 22 M.R.S.
10-144 CMR Ch 108 Home and Community Support Service Agencies Licensing Rule
This routine technical rulemaking operationalizes the statutory requirements of 34-B MRS 1203-B, Licenses for agencies that provide services to adults with certain conditions. Under this rule, any agency that provides a service, if that service is funded in whole or in part by the Department, to an adult with an intellectual disability, autism spectrum disorder, a related condition or an acquired brain injury, including a service provided under 22 M.R.S.