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All MaineCare services delivered via Telehealth must comply with Ch I, Section 4 of the MaineCare Benefits Manual (MBM). Unless otherwise specified, all services must be billed in accordance with applicable sections of the MBM. Providers must also submit claims in accordance with Department billing instructions.
Annual survey shows over 97 percent of children attending Maine's public and private schools have received required vaccines
AUGUSTA-- The Maine Department of Health and Human Services' Maine Center for Disease Control and Prevention (Maine CDC) announced today that more than 97 percent of school-age children have received all required vaccines, the second consecutive year that Maine has exceeded the "herd immunity" threshold since reporting began in 2011.
This notice provides joint guidance from the Office of MaineCare Services and the Division of Licensing and Certification (DLC).
Providers delivering IOP services covered under Chapter II, Section 65, Behavioral Health Services, must be licensed by the DLC under 10-144 C.M.R. Ch. 123 to deliver medication management because IOP services include medication management, as needed, in accordance with 65.05-5(A)(2)(d).
As a result, to be appropriately licensed to deliver IOP services, the following applies:
As we communicated yesterday, we are increasing reimbursement rates for some services that we originally planned to implement for January 1, 2025 through a COLA.
Effective June 21, 2025, Section 92 services will receive this increase, to align with the regular billing cycle. This rate adjustment is equal to an increase of 1.95% above the current rates.
The State of Maine Department of Health and Human Services aims to improve HCBS. We would like to hear about Medicaid beneficiary experiences with waiver services. For the third consecutive year, the State of Maine’s Office of Aging and Disability Services (OADS) is completing the CAHPS® HCBS survey. Knowledge Services, a survey vendor, will again assist the State with survey administration.
MaineCare is increasing reimbursement rates through a COLA for certain services that were originally scheduled for January 1, 2025. This COLA is provided in accordance with PL 2025 Ch. 2. The intent of this COLA is to increase reimbursement for direct care workers and help ensure the continuation of essential MaineCare services. The COLA will be effective July 1, 2025, and is equal to an increase of 1.95% above the currently established rates.
The Department is adopting routine technical rule changes to its rule to control specific notifiable communicable, occupational, and environmental diseases and conditions, as authorized by Maine law (22 MRS chapter 250). Amendments to this rule include adding COVID-19, Enterococcus resistant diseases, Hard Tick Relapsing Fever, Hepatitis C (acute and chronic), Mpox virus infection, PFAS serum test results and removing Rabies post-exposure prophylaxis from the notifiable diseases list, which aligns with US CDC’s priorities for state surveillance.
This is a reminder that the attending provider is required on all UB-04 and 837I claims. MaineCare denies UB-04 and 837I claims submitted without an enrolled attending provider.
The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment reported in the claim/encounter. The attending provider requirement includes all claim submission methods (paper, HealthPAS Online Portal, or 837I).
The Office of MaineCare Services (OMS) is requesting that providers include the taxonomy code on all claims. The taxonomy code is necessary for the Centers for Medicaid and Medicare Services (CMS) to collect data for Transformed Medicaid Statistical Information System (T-MSIS) reporting. This data helps to inform states of their current standing in data quality as compared to other states and is crucial for research and policy on Medicaid and CHIP. The taxonomy is also used by CMS to conduct program oversight, administration, and integrity.