Re-Entry Update #1

April 27, 2022

Good Afternoon,

The Maine Department of Health and Human Services (Department) has begun both ending its pandemic footing and preparing for a permanent telework policy effective September 6, 2022. We are calling the transition from April 25 to September 6 a “return to offices” or “re-entry” for short.

Change of Edit 6075 from Deny to Warn, CR 109501

We have identified a defect in Edit 6075 logic which is causing some claims submitted by Rural Health Clinics (RHC), Federally Qualified Health Centers (FQHC), Indian Health Services (IHS) providers, and School Health Center providers with paid encounter services to incorrectly deny the T1015 service. We will notify you when this issue is corrected and affected claims will be reprocessed. No provider action is needed. 

Please contact your Provider Relations Specialist, Tia Bolduc, with any questions.

COVID-19 Vaccines, Pre-Exposure Prophylaxis, and Treatment for Non-Hospitalized Patients

COVID-19 vaccination remains the best way to prevent infection, hospitalization, and death. COVID-19 vaccination is recommended for individuals five years and older; a booster dose is recommended for individuals 12 years and older, and a second booster is authorized for individuals 50 years and older. 

Patients who are moderately or severely immunocompromised should receive additional vaccine doses and may also receive pre-exposure prophylaxis to further reduce the risk of infection, hospitalization, and death.   

​Health PAS Online Portal Intermittent Issues

We understand you may be experiencing issues with the Health PAS Online Portal. You may have extended wait times, timing out of applications, and no response when attempting to view and submit prior authorizations, adjusting claims, or accessing certification submissions.

We are working to correct the issues as soon as possible and will send another message when they are resolved.
Please contact Provider Services with questions by email or call 1-866-690-5585.

Attention Providers of Section 21 Agency Home Support: Adjusting Past Claims for Part AAAA HCBS Agency Per Diem (T2016 and T2016 SC) Rate Increases

As of May 20, 2022, we have updated Prior Authorizations (PAs) issued prior to May 3, 2022, for Section 21 Home Support- Agency Per Diem (T2016 or T2016 SC) rate adjustments effective January 1, 2022, associated with Part AAAA of P.L. 2021, ch 398. Providers may now adjust claims for these services retroactively to January 1, 2022. Providers have 120 days from the date of this notice to adjust claims; please focus on the oldest dates of service first.

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