• Read more about Section 97, Private Non-Medical Institutions, Appendix F (PNMI-F): Rate Letters for Fiscal Year (FY) 2026, CR,132604

The Section 97, Appendix F, FY 2026 rate letters will be accessible on the secure Health PAS Online Portal by July 1, 2025. To view your rate letter(s), log into your Trading Partner Account and follow this pathway: File Exchange > Reports > Rate Setting Letters.    

If you have questions about accessing your letter(s), please contact Provider Services at 1-866-690-5585.     

For questions about the content of your letter(s), please contact Rate Setting directly by using the contact listed on the letter.

• Read more about MaineCare Issued Annual Hospital Value-Based Purchasing (VBP) Supplemental Payments

Earlier this month, MaineCare issued supplemental payments to nine hospitals rewarding the high levels of primary care utilization for MaineCare members in their Hospital Service Areas (HSAs). The table below shows how the top eight (8) HSAs, which include nine (9) hospitals, surpassed the statewide average of 57% of MaineCare members within the HSA with a primary care visit in 2024.

Jun 6, 2025

The recently passed FFY 2025 budget reconciliation bill (the "One Big Beautiful Bill Act") contains significant Medicaid (MaineCare) policy changes, including a mandatory work requirement provision for Medicaid expansion members and the removal of good faith waivers for Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC) audits with error results above a certain low threshold. This document provides an overview of the potential impacts to Maine's Medicaid program.

• Read more about Additional Impacts to Maine Medicaid (MaineCare) from Proposed Federal Changes

• Read more about Child Care Affordability Program Rules, 10-148 C.M.R. Ch. 6

This emergency routine technical rulemaking is necessary to comply with Federal Rule updates according to 42 U.S.C. 9858 et seq., 45  C.F.R. Pt. 98, which makes multiple changes to the payment structure of the Child Care Affordability Program, including:

• Read more about Child Care Affordability Program Rules, 10-148 C.M.R. Ch. 6

This routine/technical rulemaking is necessary to comply with Federal Rule updates according to 42 U.S.C. 9858 et seq., 45  C.F.R. Pt. 98. The Department adopted the changes outlined below on an emergency basis on 5/19/25, and this proposed rulemaking will adopt these changes before the emergency rule expires on 8/17/25 at 11:59pm EST (U.S. and Canada). This rulemaking proposes to promulgate on a non-emergency basis changes to the payment structure of the Child Care Affordability Program, including:

• Read more about Billing Reminder: When Services are Rendered Via Telehealth

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.

• Read more about Video test

• Read more about Maine Celebrates Record High Immunization Rates Among School Children; Prepares for Statewide Implementation of Docket for Schools

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.

• Read more about Licensing Requirements for ​Intensive Outpatient Program (IOP) Providers

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: 

• Read more about Section 92, Behavioral Health Homes (BHH) Cost-of-Living Adjustments (COLA)

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.