• Read more about Revalidate with MaineCare to Avoid Claim Denials

Per the Affordable Care Act (ACA), Section 6401, all providers need to revalidate with all states they are enrolled with.

Durable Medical Equipment (DME) providers are required to revalidate their information with MaineCare every three years. The current round of revalidation began in January 2022.  

• Read more about Microdyn Update for Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) - CRs 131553, 131554, & 131582

Effective May 10, 2025, we completed the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates in MIHMS. The following CMS documents provide the details of the APC and DRG updates:   

• Read more about Drinking Water Rule, 10-144 CMR Ch. 231

This Rule administers the State of Maine drinking water requirements for approximately 1,900 public water systems by the Department’s Maine CDC Drinking Water Program (Department), which has federal primacy.

May 5, 2025

Editor's Note: This blog was originally published on May 20 and was since updated on May 28 to reflect developments as of May 22, when the U.S. House of Representatives passed the FFY 2025 budget reconciliation bill, formally titled the One Big Beautiful Bill Act. The updated content below incorporates policy changes included in the final House-passed version.

• Read more about Federal Proposals Threaten Health Coverage, Nutrition Assistance, and Marketplace Stability in Maine

• Read more about "Don't Let a Tick Make You Sick"

The Maine CDC marks Lyme Disease Awareness Month with Prevention Tips

AUGUSTA-- The Maine Center for Disease Control and Prevention (Maine CDC) urges Maine residents and visitors to take precautions to prevent tick bites. Governor Janet Mills proclaimed May Lyme Disease Awareness Month. This year's theme is "Don't Let a Tick Make You Sick."

• Read more about Quarterly Physician Drug Code and Rate Update: QTR 2, CR 131894

In alignment with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate update, effective April 1, 2025, we retroactively updated the Physician Drug Rates. We implemented the new rates for billing on May 14, 2025. 

• Read more about Section 65 Medication Management Code Changes

New Codes

Beginning May 16, 2025, mental health and substance use agencies must use the following code modifier combinations to bill for medication management:

• Read more about SUN Bucks, SUN Meals Programs Return to Help Feed Kids During Summer Break

AUGUSTA-- The Maine Department of Health and Human Services (DHHS), through its Office for Family Independence (OFI), and Maine's Department of Education (DOE) have announced the return of the SUN Bucks and SUN Meals Programs for Summer 2025. Together, the SUN Programs help give children the nutrition they need in summer when school meals are unavailable.

• Read more about Maine CDC Provides Tips to Reduce Exposure to Browntail Moth Hairs

May 5, 2025

Since 1995, the Maine CDC Breast and Cervical Health Program has helped clients access timely breast and cervical cancer screening, diagnostic, and treatment services. The program recently expanded eligibility to include qualifying women ages 21 and older -- lowering the previous age threshold of 35.

This change reduces the risk of undiagnosed cancers and the associated consequences of pain, illness, and premature death. It also addresses two critical public health considerations:

• Read more about Expanded Access to Breast and Cervical Cancer Services for Maine Women 21+