MaineCare Provider Training Opportunities
Health PAS Online Portal Training
Gainwell Technologies continues to offer weekly training through Microsoft Teams on the following Health PAS Online Portal topics:
HIV Prevention for Medical Practitioners
The Department is offering a series of HIV focused webinars. The first, led by Dr. Stephen Rawlings, covers the latest in HIV pre-exposure prophylaxis (PrEP) including a review of the twice-yearly injectable PrEP drug Yeztugo.
Dr. Rawlings, a MaineHealth practitioner, is Board certified in Infectious Diseases and Internal Medicine. He seeks opportunities to teach at all levels so that we can all enjoy the best medical care possible.
Children’s Behavioral Health & Residential Treatment
Applying for Children’s Residential Care Facility Services
CBHS contracts with Acentra to manage Children’s Residential Care Facility Services (CRCF). Children’s Residential Care Facility Services for children follows the MaineCare Section 97 eligibility criteria. Acentra processes all applications and completes Prior Authorizations for Children’s Residential Care Facility Services, and they are your contact related to approval for admissions to Children’s Residential Care Facility.
10-148 C.M.R. ch. 31; Quality Rating and Improvement System: Rising Stars for ME
This rule outlines how the Maine Department of Health and Human Services (the Department) pays a differential rate for child care services that meets or that makes substantial progress toward meeting nationally recognized quality standards, as required by 22 M.R.S.A § 3737. The emergency rulemaking allows the Department to immediately start paying a higher quality differential to such early care and education programs, addressing the lack of access to high-quality early care and education programs in Maine, which presents an ongoing threat to Maine’s general welfare.
Critical Access Hospitals (CAHs) Swing Bed and Nursing Facility (NF) Days Awaiting Placement (DAP) Rate Updates, CRs 134801, 134803
Effective July 1, 2025, the CAH swing bed and NF DAP rates are recalculated for State Fiscal Year 2026. You can view both related memos on the rate setting page of the Health PAS Online Portal.
10-144 C.M.R. Ch. 301; Supplemental Nutrition Assistance Program (SNAP) Rules; Sections 555-4 and 555-5
10-144 C.M.R. Ch. 301 – Supplemental Nutrition Assistance Program (SNAP) Rules; Sections 555-4 and 555-5
EMERGENCY RULE: SNAP Rule #242E – Income and Deductions Update
Effective Date:
September 18, 2025
Delayed July 1, 2025, Cost-of-Living Adjustment (COLA) for Section 97, Appendix C, Residential Care Facilities (RCFs)
The Department is temporarily delaying implementation of the previously announced 1.0% COLA rates for RCF direct care. The Department requires additional time to make these updates, and we anticipate implementation of new rates on October 1, 2025.
Billing Guidance for Dates of Service July 1, 2025, through September 30, 2025
Seasonal Flu Codes Updated Effective August 1, 2025, CR 134495
Effective August 1, 2025, MaineCare updated seasonal flu codes. See the table below for the new rates.
|
Start Date |
End Date |
Procedure Code |
Rate |
|
8/1/2025 |
|
90653 |
$98.16 |
|
8/1/2025 |
|
90656 |
Update to 2024 InterQual Criteria Sheets, CR 126309
Effective September 12, 2025, we updated InterQual criteria sheets on the MaineCare Health PAS Online Portal. The criteria sheets are used to establish the medical necessity of the requested services. All decisions must align with the most current criteria sheet.
30 Day Transition Period (September 22, 2025 – October 22, 2025)