Updated Payment Rate Details for Substance Use Disorder (SUD) Intensive Outpatient Program (IOP) Service Providers, CR 110559
Effective June 29, 2022, we have updated the rate for Sections 65, Substance Use Disorder (SUD) Intensive Outpatient Program (IOP) services in MIHMS retroactively to January 1, 2022. These rates are now ready to bill.
Primary Care Plus (PCPlus) Orientation Events
PCPlus is MaineCare’s new value-based approach to support the primary care system, improve healthcare quality, and reduce inefficient health care spending. PCPlus gives primary care providers greater flexibility and incentives to meet MaineCare members’ healthcare needs.
Over 230 primary care practices are expected to participate in PCPlus starting July 1, 2022. Participation includes:
Dental Prior Authorization (PA) Forms, CR 110373
Effective July 1, 2022, we have updated the Prior Authorization (PA) process for dental services. We have updated some dental PA forms. Please see below for more information about the changes that are in effect on July 1, 2022.
Please discontinue use of these forms:
- Dentures PCP PA Form
- Supplemental Denture PA Form
Please use the following new forms:
UPDATE for Providers Billing on UB-04 and 837I Claims, CR 107682
Effective August 31, 2022, UB-04 and 837I claims submitted without an attending provider will be denied.
MaineCare Benefits Manual, Chapter II, Section 25, Dental Services (repeal); Chapter III, Section 25, Allowances for Dental Services (repeal); Chapter II, Section 25, Dental Services and Reimbursement Methodology (rule replaces the two repealed rules)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
Re-entry Update #8
June 30, 2022
Good afternoon,
Just a quick reminder that tomorrow is the last day for workers to fill out the DHHS Telework Approval Forms which can be found at the Office Re-entry Planning for DHHS site. We encourage you all to fill it out, even if you prefer not to telework. After tomorrow, this Form will be used for updated and adjusted schedules, new workers, and workers whose supervisors subsequently determine that they are eligible for telework.
Re-entry Update #7
June 27, 2022
Good morning,
This is the last week for workers to fill out the DHHS Telework Approval Form. The deadline is Friday, July 1.
All the information you need to know can be found at the Office Re-entry Planning for DHHS page (you can also navigate to it by visiting the DHHS homepage, hovering on “About Us” then clicking on “Staff” and scrolling down to the bottom of the page – it is the last bullet).
MaineCare in Education: Correction to TM and TL Modifier Language for Private Duty Nursing (PDN) Medical Necessity
Earlier today, we sent a message that included incorrect detail about using TM and TL modifiers. See the bolded bullet list below for corrected language.
Attention Home Health Service Providers: Tomorrow, July 1, 2022 EVV Soft Launch Implementation
This message is another reminder about the Electronic Visit Verification (EVV) “soft launch” period for providers of section 40 Home Health and section 43 Hospice services ahead of the January 1, 2023 federal implementation deadline that was originally announced August 13, 2021.