Re-entry Update #10
July 25, 2022
Good morning,
On Friday, July 29, we are hoping to round out the third phase of implementing the Department of Health and Human Services’ Telework Policy. This month supervisors review workers’ requests. These reviews will help us plan office space, coverage, and meetings.
MaineCare in Education: Instructions for Providers of Section 28 and Section 96 Services Experiencing Difficulties with Modifier Guidance for Education-related Services
On May 17, 2022, MaineCare issued billing guidance, MaineCare in Education: New Modifier Guidance for Sections 28 and 96, that all providers submitting claims for Individuals with Disabilities Education Act (IDEA) services delivered under Section 28 or Section 96 of the MaineCare Benefit Manual should include the TL or TM modifier on the claim line to indicate if the service w
Attention Section 90 Providers: Upcoming Changes for Billing Topical Fluoride Varnish
On August 22, 2022, the Department will remove Dental Procedures and Nomenclature (CDT) code D1206, Topical Application of Fluoride Varnish, from non-dental provider contracts so that it is no longer billable by non-dental providers. This change is part of the rulemaking for MaineCare Benefits Manual, Chapter II, Section 90, Physician Services, which was adopted on May 9, 2022.
MaineCare’s HOME Provider Orientation Webinar Dates and Application Opening on July 22, 2022
HOME Services Provider Orientation
Effective July, 22, 2022, MaineCare is accepting Housing Outreach and Member Engagement (HOME) Provider applications from providers interested in delivering HOME services for eligible individuals experiencing long-term homelessness, as described in the newly adopted MaineCare
MaineCare Launches New Payment Model to Improve Primary Care Services
Jul 7, 2022
The Office of MaineCare Services has launched Primary Care Plus (PCPlus), a new initiative to support primary health care, advance health care quality, and improve the efficiency of health care spending. PCPlus enables MaineCare to replace the prior outdated and convoluted system of payments and offer primary care practices a single, integrated process for reimbursement with greater flexibility and incentives to meet MaineCare members’ health care needs.
Drug Rate Updates
Additional 2021 Drug Rate Updates, CR 106867
On January 12, 2022, we updated certain drug code rates retroactively to either January 1, 2021, or July 1, 2021, in MIHMS based on updates from the Centers for Medicare & Medicaid Services (CMS).
Rate Update for 2022 Ambulatory Surgical Centers (ASC) Rates, CR 107519
On February 10, 2022, as part of a regular annual update, we updated the rates for MaineCare Benefits Manual, Chapter II, Section 4, Ambulatory Surgical Center Services, in MIHMS retroactively to January 1, 2022.
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 25 (repeal); Chapter III, Section 25 (repeal) and Chapter II, Section 25, Dental Services and Reimbursement Methodology (replaces the two repealed rules)
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed
Office of Aging and Disability Services Virtual Listening Session to Access Technology for Individuals with Intellectual and Developmental Disabilities
The Department of Health and Human Services (DHHS) Office of Aging and Disability Services (OADS) is hosting a virtual listening session to gather input on Supporting Access to Technology by Individuals with Intellectual and Developmental Disabilities (IDD).