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On October 2, 2023, the Office of MaineCare Services (OMS) sent a bulletin regarding the coverage of COVID-19 vaccines. OMS has determined reimbursement rates for COVID-19 vaccine codes and their administration as outlined below. Please continue to hold claims until our systems are updated, at which time an additional e-message will be sent.
In response to the federal Public Health Emergency (PHE), Maine established temporary changes to its five existing federally approved 1915(c) home and community-based waivers through a standalone Appendix K: Emergency Preparedness and Response amendment.
Effective October 1, 2023, a maximum of 100 blood glucose test strips will be available every 90 days without Prior Authorization for members utilizing CGM.
In November of 2022, MaineCare provided notice that we had initiated a rate determination process for Section 30, Family Planning Agency Services, Chapter II & III of the MaineCare Benefits Manual (MBM). We are developing a family planning agency APM to reflect a team-based, patient-centered, integrated care model.
This is a follow-up to our e-message on April 6, 2023, that stated MaineCare has delayed the application of the true PBA portion of the monthly population-based payment to PCPlus practices. PCPlus practices will continue to receive the standard PBA until further notice.
This notification is a reminder for providers to use the correct and current Vendor Activation form when establishing or updating an account with the State of Maine's accounting system. This form is now available to download within the Provider Enrollment Application (PEA) under the Supporting Documents screen.
MaineCare temporarily excluded Hospice services from EVV requirements as of March 15, 2023.
Aligning with the adoption of the MBM, Chapter II, Section 60, Medical Supplies and DME rule, the Office of MaineCare Services (OMS) will be updating the criteria sheets used when submitting a request for PA. The criteria sheets will be located on the HealthPAS portal as of October 31, 2023, using the path MaineCare Information>Manual, Forms, and Criteria Sheets and are as follows:
The Office of MaineCare Services academic detailing partner, Maine Independent Clinical Information Service (MICIS), offers one-page non-commercial infographics that share key points for pharmacologic RSV prophylaxis in first, second, and third generations: adults over 60, pregnant people, and infants, respectively. The infographics can be accessed following the links below:
The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.
We continue to offer weekly provider and aggregator trainings. All trainings are online via Microsoft Teams.
NOTE: The Absorb training system has been updated to allow providers to register for trainings more than once.
EVV Training Schedule