• Read more about Attention Providers of Section 45, Hospital Services: Draft Rate Model Public Meeting

PUBLIC COLLABORATION 

MaineCare is conducting a rate study for Section 45 of the MaineCare Benefits Manual. This study is being performed by Burns and Associates, a division of Health Management Associates.

MaineCare is holding an online public meeting on December 19, 2022, to obtain important feedback regarding a draft reimbursement model specific to inpatient discharges at distinct psychiatric units and distinct substance use disorder units.   

• Read more about MaineCare Provider and Member Services Closing Early

MaineCare Provider and Member Services Call Centers will be closing at 4:00 PM on Friday, December 9, 2022.   

The MyHealth PAS Online Portal and the IVR self-service options will continue to be available during this time; however, the option to speak with a call center professional will not be available.    

Business will resume to normal hours on Monday, December 12, 2022, from 7:00 AM EST until 6:00 PM EST.

• Read more about Attention Section 28 Providers: Update on Type 92 Early Childhood Provider Certification Letters, CR 71822

MaineCare now requires accurate certification information for Section 28 Type 92 providers prior to approval for that provider type. The certification consists of an approval letter from the Maine Department of Education that indicates the approval period. Certification dates in the provider’s enrollment case should match the certification end-date to prevent claims from being approved for payment if the certification is not valid. Please note that providers who have not already done so, their contract was end-dated on or around November 1, 2022.

• Read more about Updated 340B Agreement Form 

The 340B Agreement Form was updated and posted to t

• Read more about Donor Breast Milk Coverage, CR 113451

On January 1, 2023, MaineCare will add coverage for donor breast milk (CPT code T2101 - Human breast milk processing, storage, and distribution) under Section 90, Physician Services, and Section 45, Hospital Services, in accordance with Maine P.L. 2021, Ch. 708 (L.D. 85), An Act Concerning MaineCare Coverage for Donor Breast Milk.

• Read more about Section 23: Foster Care Comprehensive Health Assessment Rates and Reimbursement Methodology

PUBLIC REVIEW AND COMMENT

• Read more about MaineCare Cost of Living/Part AAAA Adjustments

MaineCare is increasing reimbursement rates for certain services through a cost-of-living adjustment (COLA) as directed by Maine P.L. 2021 ch. 639 and 22 MRSA Section 7402, as enacted by Maine P.L. 2021, ch. 398, Part AAAA. The COLA will be effective January 1, 2023, and is equal to an increase of 8.24% above the currently established rate(s). 

• Read more about Attention Providers of Opioid Health Homes, Behavioral Health Homes, and Community Integration

The Department of Health and Human Services recently released an alert on a service disruption in Southern Maine that may have impact to several hundred Mainers. Please coordinate with your member regarding service delivery and or referral needs.     

Please refer to the following notice from October 27, 2022. 

• Read more about October 2022 Microdyn Update for Ambulatory Payment Classifications (APC)

Effective November 20, 2022, the Centers for Medicare & Medicaid Services (CMS) quarterly updates have been updated in MIHMS. The following CMS documents provide the details of the October 2022 APC updates:   

• Read more about Attention Behavioral Health Providers: Sign up for the New Service Locator Tool Webinar

The Department of Health and Human Services (DHHS) is excited to announce the creation of a Service Locator Tool through vendor Bamboo Health that will improve how Maine residents access substance use and mental health treatment. The tool is available through the following link: TreatmentConnection.com.