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On March 5, 2025, MaineCare announced the Department would need to temporarily hold certain provider payments beginning with the payment cycle that ran on March 12, 2025. As of the time of this message, the Legislature has not approved the necessary funding, by way of an emergency supplemental budget, to avoid these measures.
Notice of Agency Waiver Renewal
AGENCY: Department of Health and Human Services (DHHS), Office of MaineCare Services
RULE TITLE OR SUBJECT: 1115 Waiver Renewal Application
WAIVER: Section 1115(a) waiver demonstration, “Maine Substance Use Disorder (SUD) Care Initiative"
MaineCare is receiving reports regarding increased member concern about the status of their MaineCare coverage as a result of the temporary hold on certain provider payments. The temporary holds on provider payments do not affect MaineCare coverage for members.
MaineCare sent this electronic message to our member list serv on March 10, 2025, regarding impact on members.
When billing MaineCare secondary claims, you must attach an EOB to all claims regardless of the submission type listed below:
When submitting electronically, upload the EOB after the claim is in MIHMS. The charges billed on the claim lines must match the charges billed on the EOB, or the claim will be denied.
Maine CDC Children & Youth with Special Health Care Needs invites you to join us for an insightful webinar about the basics of WIC. This webinar will provide a general overview of the services offered by WIC and how they can be accessed.
At the end of this presentation, participants will:
When: April 1, 2025, 3:30 - 4:30 PM
We implemented new rates for Section 4, ASCs retroactively to January 1, 2025.
You may view the updated fee schedule on the rate setting page of the Health PAS Online Portal.
Adjusting Claims
Effective January 1, 2025, MaineCare updated the Anesthesiology conversion factors for Sections 14 and 90 of the MaineCare Benefits Manual. You may view the updated fee schedules on the rate setting wepage of the Health PAS Online Portal.
We implemented new rates for Sections 68, 85 and 109 retroactively to January 1, 2025.
You may view the updated fee schedules on the rate setting page of the Health PAS Online Portal.
Adjusting Claims
On March 14, 2025, we held the Annual Draft Rate Determination Schedule Consultation with the TAP which was open to the public.
The Division of Licensing & Certification (DLC) provides regulatory oversight of medical and long-term care facilities in Maine. This includes oversight of the CNA registry, criminal background checks for employers to ensure staff are safe to care for our vulnerable citizens, and investigations into allegations of unsafe practices/events in facilities as diverse as hospitals, nursing homes, assisted living facilities, and group homes.