Updated MaineCare in Education 2022 Guide
Please review and download the MaineCare in Education 2022 School Health-Related Services Billing Guide. The guide is available on the
Enteral Nutrition and Supply Codes Added to the Diabetic Supply Service Group, CR 107707
We have added enteral nutrition and supply codes to the Diabetic Supply Service Group to correct an issue that was causing claims to deny.
Enteral nutrition and supply codes that were submitted with overlapping dates, paid by Medicare, and crossed over to MaineCare in the Medicare claim file were denying as duplicates. We have corrected this issue by adding the codes to the Diabetic Supply Service Group. We will adjust affected claims, and no provider action is necessary.
Attention All Providers: Payment Error Rate Measurement (PERM) Audit
The State of Maine has completed the process of a federally mandated PERM audit for Reporting Year 2021. The information below will help you avoid errors that could result in the need to pay MaineCare back.
This audit covered randomly selected paid claims with payments dated July 1, 2019, through June 30, 2020. See the e-message from February 6, 2020, that notified providers about the audit.
Claims Submission
Status of Home and Community Based Services (HCBS) Settings Rule Requirements
Earlier this week at a provider association meeting, an official from the Centers for Medicare and Medicaid Services (CMS) indicated that CMS is likely to give states the option to request additional time to comply with some aspects of the federal HCBS Settings Rule. The Department has received questions about what this means for Maine’s current compliance efforts.
Reminder: Primary Care Plus (PCPlus) Application Closes Today
PCPlus is an adopted MaineCare policy that supports primary care practices in delivering high-quality primary care. We anticipate that this policy will have a future effective date of July 1, 2022.
Instructions to Apply for Retainer Payments for Providers of MaineCare Benefits Manual (MBM), Sections 18, 20, 21, and 29 Services
This is a follow up to the August 30, 2021 e-message and September 24, 2021 e-message regarding Home and Community Based Services (HCBS) Retainer
Attention All MaineCare Providers: Updated Alternative Settings Guidance
Under the Department’s approved Section 1135 waiver, the Centers for Medicare & Medicaid Services (CMS) has granted us the ability to waive certain federal Medicaid requirements during the COVID-19 federal public health emergency.
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapters II and III, Section 91, Health Home Services
Notice of Agency Rule-making Adoption
AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy
CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapters II and III, Section 91, Health Home Services
ADOPTED RULE NUMBER:
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter II, Section 90, Physician Services
Notice of Agency Rule-making Adoption
AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy
CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 90, Physician Services
ADOPTED RULE NUMBER:
CONCISE SUMMARY: This final rule makes the following changes: