• Read more about Attention Providers: New Ways to Connect Your Patients to Mental Health Care

The MaineCare HIV Program and the Delivery System Reform Units will host a 30-minute tour of Treatment Connection, an online platform that helps you locate and contact mental health and substance use disorder (SUD) providers. This session is specifically for providers who seek mental health and SUD services for their patients. The live event will start at 11:30 AM, Thursday, January 25, 2024. Register Here. (Recording will be posted).

• Read more about MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual Chapter II, Section 29

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed rules on fi

Jan 1, 2024

Today, the Maine Department of Health and Human Services (DHHS) released an update on the resumption of MaineCare (Medicaid) eligibility reviews after the COVID-19 Public Health Emergency, known as “unwinding.”  During the first eight months of the unwinding period (from May to December, 2023), the Department’s efforts have resulted in over 204,000 MaineCare members successfully renewing or retaining coverage.

• Read more about Maine DHHS provides update on MaineCare “unwinding”

• Read more about Provider Enrollment Presentation Session Materials​

On January 17, 2024, the Office of MaineCare Services (OMS) hosted a provider enrollment presentation and listening session. During this session OMS and Gainwell Technologies delivered presentations on the provider enrollment process and listened to comments from providers.  

• Read more about ​​Comment Deadline Extended: Mobile Crisis Response Teams, Draft Service Model and Rates​

MaineCare is extending the Mobile Crisis Response Teams draft rate model comment deadline from January 26, 2024, to February 9, 2024. 

Please consider sending comments earlier if possible, to allow the Department to continue to make progress. Comments should be submitted to Karl Matzinger of HMA-Burns at the following email: kmatzinger@healthmanagement.com   

• Read more about The American Society of Addiction Medicine (ASAM) 4th Edition Release

The ASAM Criteria, nationally recognized as the gold standard in treatment assessment, was first developed in 1990. A new edition, The ASAM Criteria 4th edition, was released in December 2023, with subsequent volumes including:

• Read more about MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual Chapter II, Section 29

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed rules on fi

• Read more about Medicare Standardization Rate Updates for Calendar Year 2024 (CY24)

The Department is in the process of updating reimbursement rates for Medicare covered codes and services for the sections noted below, to be effective January 1, 2024. The new rates will reflect 72.4% of the most recent, 2024 Medicare rates.  

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

Effective January 1, 2024, the Department has updated DME rates benchmarked to Medicare, to reflect 100% of current year Medicare rates. New rates have been posted to the MIHMS portal and rates will be implemented for billing on January 24, 2024.

Adjustment of Claims

• Read more about Quarterly Physician Drug Code Update

Effective January 1, 2024, the Department has retroactively updated the Physician Drug Rates in alignment with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate update. These new rates will be implemented for billing on January 24, 2024.