DHHS → node
Effective September 16, 2025, referrals for Section 97, Appendix E, PNMI Services will not undergo clinical review until referents submit all required documentation through the Atrezzo system. Acentra will place incomplete referrals on an administrative hold for up to seven days.
Ensuring Referral Processing
As previously noticed, MaineCare is increasing all in-state FQHC rates to reflect a 1.0% COLA.
MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.
As previously noticed, MaineCare is adjusting the RCF direct care rates to reflect a 1.0% COLA.
MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.
As previously noticed, MaineCare is increasing certain hospital reimbursement rates to reflect a 1.0% COLA.
MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.
The following is being adjusted to reflect the COLA increase:
As previously noticed, MaineCare is increasing reimbursement rates for Sections 91 and 93 to reflect a 1.0% COLA.
MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to June 21, 2025, to align with the regular billing cycle for these services.
Section 97, Appendix F, FY 2026 rate letters will be accessible on the secure Health PAS Online Portal by September 24, 2025. To view them, log into your Trading Partner Account and follow this pathway: File Exchange > Reports > Rate Setting Letters.
If you have questions about accessing the letters, please contact Provider Services at: 1-866-690-5585.
For questions about the content of these letters, please contact the individual listed on the rate letters.
As previously noticed, MaineCare is increasing certain hospital reimbursement rates to reflect a 1.0% COLA.
MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.
On December 29, 2025 the State of Maine received official notification (PDF) from the U.S. Centers for Medicare & Medicaid Services (CMS) of a $190 million award for Year 1 of the federal Rural Health Transformation Program.
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.