Update to the Biosimilar Preferred Drug List
Effective January 4, 2024, the Department will add preferred and non-preferred drugs to the Biosimilar Preferred Drug List (PDL).
The Department will add the following preferred drugs:
Impact to MaineCare of Average Manufacturer Price (AMP) Cap Removal
As the result of a provision in the American Rescue Plan (ARP) Act of 2021, beginning January 1, 2024, Medicaid rebates from drug manufacturers will no longer be capped at 100 percent of the quarterly AMP.
EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) App
- Read more about EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) App
EVV Providers who are currently using the SMC app through their phone, tablet, or other mobile device should update to the latest version of the app using the Apple Store, or Google Play. The current version of the app is being phased out and will no longer be active. To avoid any interruption of visit record keeping, you should now download the app that has a version number of 3.0 or higher.
CORRECTION: Non-Billing, Ordering, Prescribing, and Referring (NOPR) Editing Changing from Warn to Deny – CR 121469
This message serves as a correction to information provided in our December 27th e-message regarding Non-Billing, Ordering, Prescribing, and Referring (NOPR) Edits.
CORRECTION: Intermediate Care Facilities (ICF) Rate Letters for CY 2024 and Day Habilitation Service Rate Update – CR 121701
This notice corrects our earlier reference to Section 50 as an Intensive Care Facility. Section 50 is an Intermediate Care Facility.
Rate Letters
Section 50, Intensive Care Facilities (ICF) Rate Letters for Calendar Year (CY) 2024 and Day Habilitation Service Rate Update - CR 121701
Rate Letters
The CY 2024, ICF-IID rate letters are now available on the Health PAS Online Portal. You can view them by logging into your Trading Partner Account and following this pathway: File Exchange > Reports > Rate Setting Letters.
Section 103, Rural Health Center (RHC) Calendar Year 2024 (CY24) Rate Update - CR 121608
Effective January 1, 2024, the Section 103, RHC CY24 rate letters will be accessible on the secure Health PAS Online Portal. You can view them by logging into your Trading Partner Account and following this pathway: Exchange > Reports > Rate Setting Letters.
Rescheduled MaineCare Provider Enrollment Presentation and Listening Session
This is a follow-up message about the previously scheduled event that was cancelled due to inclement weather and State office closure. We have rescheduled the Provider Enrollment Presentation to January 17, 2024, 9:00 – 10:30 AM. Please see the details below.
MaineCare Benefits Manual, January 1 Cost-of-Living Adjustments
Notice of MaineCare Reimbursement Methodology Change
AGENCY: Department of Health and Human Services, Office of MaineCare Services
SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, January 1 Cost-of-Living Adjustments
MaineCare Benefits Manual, Section 97, Private Non-Medical Institution Services, Appendix C
Notice of MaineCare Reimbursement Methodology Change
AGENCY: Department of Health and Human Services, Office of MaineCare Services
SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Section 97, Private Non-Medical Institution Services, Appendix C