Correction to Zoom Link - Attention: Listening Session for MaineCare Residential Substance Use Disorder (SUD) Providers

Effective July 1, 2023, Acentra Health (formerly Kepro) began reviewing residential SUD admissions for MaineCare members to assess appropriate American Society of Addiction Medicine (ASAM) level of care as one of the tasks associated with MaineCare’s 1115 SUD waiver.

The Department will hold a listening session to hear from impacted providers about the process to date. Please join us on September 22, 2023, from 10AM-11AM through Zoom.

Registration link:  

Durable Medical Equipment (DME) Codes Removed from the Usual, Customary and Reasonable (UCR) Fee Schedule, CR 116322

Effective August 23, 2023, all DME codes have been removed from the UCR Fee Schedule on the Health PAS Online Portal. To access the DME code fees, go to the Section 60 folder on the portal.  

If you have questions, please email Provider Services or call 1-866-690-5585. TTY users dial 711. 

Correction: Guidance for Psychiatric Hospitals Seeking Prior Authorization (PA) for Mental Health Intensive Outpatient (IOP) Services

On August 18, 2023, the Office of MaineCare (OMS) notified providers of IOP services regarding the upcoming requirement to submit a PA through the Atrezzo system operated by Acentra Health (formally Kepro) and adhere to the substantive standards set forth in MBM, Chapter II, Section 65, Behavioral Health Services.    &

Pharmacies, ​Help Your Patients Act Now to Avoid a Gap in Their Health Coverage​ 

The Office of MaineCare Services is working to raise awareness about the need for people with MaineCare to renew their coverage or, if they’re no longer eligible, to enroll in coverage through their employer or through CoverME.gov, Maine’s Health Insurance Marketplace.    

How pharmacies can help:  

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).

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