Dec 12, 2023

Today, the Maine Department of Health and Human Services (DHHS) released a Plan Selection Snapshot on early enrollment in private health insurance through CoverME.gov for 2024. A month into Open Enrollment on CoverME.gov, DHHS reports a year-over-year increase in new enrollees, including those transitioning from MaineCare coverage, and more than one in six returning members have actively made changes to their plan selections.

• Read more about CoverME.gov Open Enrollment Shows Early Positive Trends as Important Health Coverage Transitions Continue

• Read more about REMINDER: Behavioral Health and Targeted Case Management Supplemental Payment Reporting Due by December 8, 2023

• Read more about Update to the ​Biosimilar Preferred Drug List (PDL)​

Effective January 4, 2024, the Department will add preferred and non-preferred drugs to the PDL. 

The Department will add the following preferred drugs:  

• Q5122 – Nyvepria, pegfilgrastim-apgf  

The Department will add the following non-preferred drugs:  

• Read more about Attention Section 43 Hospice Services Providers: Anticipated Electronic Visit Verification (EVV) Implementation Delayed Until July 1, 2024

As of March 15, 2023, MaineCare temporarily excluded hospice services from EVV requirements as a delayed enforcement of our approved State Plan requirements.

The Department anticipates adopting MaineCare Benefits Manual Ch. II, Section 43: Hospice Services rule which will end the temporary exclusion on July 1, 2024.

• Read more about Evergreen Data System Training

Evergreen Micro Learning Videos

These short videos will teach you about the basic Evergreen functionality. It is recommended that the videos be watched in the order they are posted, as some videos refer to the content provided in other videos.

Recommended viewing order:

• Read more about SNAP Rule #229P - Electronic Benefit Theft

Pursuant to the Consolidated Appropriations Act 2023 (CAA 2023), Public Law 117-328, Division HH, Title IV Section 501, EBT Benefit Fraud Prevention requirements, the Department proposes to amend the SNAP Manual, Section 777-4 to align with the requirements of the CAA 2023. The proposed rule changes will provide clarity on the Department's procedure and timeframes for replacement of SNAP benefits determined to have been stolen through card skimming, card cloning, or similar fraudulent methods. The U.S.D.A.

• Read more about SNAP Rule #230A - ABAWD Geographic Waiver

Federal Supplemental Nutrition Assistance Program (SNAP) regulations provide that certain able-bodied adults without dependents (ABAWDs) are subject to a maximum of three months of benefits over a 36-month period, unless they work 80 hours per month or participate in and comply with requirements of a work program. Individuals who reside in certain geographic areas can qualify for an exception to this time limit under 7 C.F.R. 273.24(f).

• Read more about Attention Section 45, Hospital Service Providers: Draft Rate Model Public Forum

In June 2023, MaineCare provided notice that it initiated a rate determination for Section 45, Hospital Services, pursuant to the principles and processes under PL 2021, ch.639, An Act to Codify MaineCare Rate System Reform. &nbsp

• Read more about Electronic Visit Verification (EVV) Phase 2 Trainings

The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.

We continue to offer weekly provider and aggregator trainings. All trainings are online via Microsoft Teams.

NOTE:  The Absorb training system has been updated to allow providers to register for trainings more than once.

EVV Training Schedule

• Read more about Family Planning New Alternative Payment Model (APM) Public Rate Forum Presented Materials and Comment Deadline

On November 20, 2023, MaineCare held an online public meeting with its vendor Manatt Health Strategies, LLC., to present the recommended draft Family Planning APM, along with rationales. Stakeholders were able to provide public comment during this forum.