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This bulletin provides notice that the Department initiated a Rate Determination Process* for Section 65 of the MaineCare Benefits Manual in Spring 2022, prior to P.L. 2022 Ch. 639 becoming effective.
The Department is conducting this rate determination pursuant to the Department’s rate reform priorities, P.L. 2021, Ch. 398, and P.L. 2022, Ch. 635.
This is an update to the August 10 message on rate letters for Nursing Facilities (NF) and Residential Care Facilities (RCF PNMI C). In that message the Department committed to sending the following information by the end of August:
MaineCare now requires accurate certification information for 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.
Effective April 06, 2022, and April 27, 2022, we updated the rates in MIHMS for MaineCare Benefits Manual Section 90 codes, retroactively to January 1, 2022. You can view them on the Health PAS Online Portal.
On August 5, 2022, the Office of MaineCare Services (OMS) released a bulletin regarding planned MaineCare coverage of Monkeypox diagnostic testing and vaccines. This message is an update to that August 5th message.
The State of Maine has completed the process of a federally mandated Payment Error Rate Measurement (PERM) audit for Reporting Year 2021. (See e-message sent 02/06/2020.) This audit covered randomly selected paid claims with payments dated July 1, 2019, through June 30, 2020.
Claims Submission
On August 17, 2022, the Office of MaineCare Services (OMS) released a bulletin regarding the Emergency Use Authorization (EUA) for Novavax COVID-19 vaccine in individuals age 18 and older.
Effective August 20, 2022, we have updated MIHMS with the Centers for Medicare & Medicaid Services (CMS) quarterly updates. The following CMS documents provide the details of the updates:
July 2022 Integrated Outpatient Code Editor Specs: r11434cp.pdf (cms.gov)
Please review the reminder below pertaining to record retention requirements.
Are timesheets still required after implementation of the federal Electronic Visit Verification (EVV) requirement?