• Read more about MaineCare Notice of Agency Rulemaking Proposal, MaineCare Benefits Manual, Chapter II, Section 97 Private Non-Medical Institution Services

Notice of Agency Rule-making Proposal

AGENCY: Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND RULE TITLE: 10-144, C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 97 Private Non-Medical Institution Services

TYPE OF RULE: Routine Technical

PROPOSAL FILING NUMBER:

Feb 2, 2026

CoverME.gov is Maine's state-based health insurance marketplace, administered by the Maine Department of Health and Human Services' Office of the Health Insurance Marketplace. The 2026 Open Enrollment period recently ended, during which individuals and families were able to compare and enroll in private health insurance plans and determine eligibility for financial assistance.

• Read more about Preliminary 2026 Open Enrollment Data Shows Rising Affordability Challenges for Mainers' Health Coverage

• Read more about Single Assessment Launch on Feb. 2 - Referral Link for Non-BH Providers

Effective today, February 2, 2026, the Office of MaineCare Services (OMS) and the Office of Behavioral Health (OBH) launched the new Single Assessment process for determining eligibility for medium- to high-intensity behavioral health services. 

External Single Assessment Referral Link 

• Read more about Coverage Clarification for Pyzchiva

The Office of MaineCare Services received inquiries about Pyzchiva (ustekinumab-ttwe) appearing under different manufacturers. This notice aims to clarify coverage.

Please note the following: 

• Read more about Section 60, Durable Medical Equipment (DME) and Supplies: Annual Rate Adjustment - CR 137488

Effective January 1, 2026, MaineCare updated DME rates benchmarked to Medicare, to reflect 100% of current year Medicare rates. The new rates are available on the Rate Setting page of the Health PAS Online Portal.

Adjustment Billing Guidance for Dates of Service January 1, 2026, through January 28, 2026

• Read more about The Single Assessment for Medium- to High-Intensity Services - For Providers

Tools and Resources

• The Single Assessment - What it is and when to use it (PDF)
• Medium- to high-in

• Read more about The Single Assessment for Medium- to High-Intensity Services - For Families

Tools & Resources

• The Single Assessment - What it is (PDF)
• Medium- to high-intensity Services (PDF)

• Read more about MaineCare Notice of Agency Emergency Rule-making Adoption: MaineCare Benefits Manual, Chapter II, Section 13

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. 

• Read more about MaineCare Notice of Agency Rule-making Emergency Adoption, MaineCare Benefits Manual, Chapter II, Section 92, Behavioral Health Home Services and Chapter III, Section 92, Principles of Reimbursement for Behavioral Health Home Services

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.  

• Read more about MaineCare Notice of Agency Emergency Rule-making Adoption: MaineCare Benefits Manual, Chapter I, Section 7, Children’s Behavioral Health Services Global Rule

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.