• Read more about Rate Determination Kickoff Meeting: Sections 12, 18, 19, 20, 21, 29, 40, 96, & 102, Home & Community Based Services (HCBS) Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, & Assistive Technology Services

Earlier this year, MaineCare provided notice that it had initiated a rate determination process for certain HCBS services provided under Sections 12, 18, 19, 20, 21, 29, 40, 96, & 102, of the MaineCare Benefits Manual (MBM).   

• Read more about Section 92, Behavioral Health Homes (BHH): Implementation of Cost-of-Living Adjustments (COLAs) Effective December 21, 2023, CR 125416

As previously noticed on December 1, 2023, MaineCare is increasing reimbursement for Section 92 BHH services through a 2.54% COLA. The implementation of this COLA had been “pending approval of appropriations.”

• Read more about Sections 2, 13, 17, 26, 28, and 65: Implementation of Cost-of-Living Adjustments (COLAs) Effective January 1, 2024

On December 1, 2023, MaineCare provided notice that it would increase reimbursement for certain eligible services through a 2.54% COLA, to be effective January 1, 2024. The notice indicated a status of “pending approval of appropriations” for several eligible services (under Sections 2, 13, 17, 26, 28, and 65).

• Read more about Attention Pharmacy Providers: Status of Restoration of Maine Point of Purchase System (MEPOPS) and Office Hours with MaineCare’s Pharmacy Team

The Office of MaineCare Services continues a phased recovery following the outage that occurred from February 21, 2024, through March 26, 2024, due to the national cyber security issue affecting Change Healthcare. 

We are entering the next phase of the recovery and are continuing to restore waived edits. On May 1, 2024, Reject – 79 Refill Too Soon and Reject-79 Refill Too Soon Carryover were returned to normal functioning. On July 17, 2024, Reject-76 Plan Limitations Exceeded, returned to normal functioning.   

• Read more about Attention MaineCare Providers: Notice of Returning Pharmacy Processes Including Prior Authorizations

The Office of MaineCare Services continues a phased recovery following the outage that occurred from February 21, 2024, through March 26, 2024, due to the national cyber security issue affecting Change Healthcare. 

During the outage, limitations were waived regarding medications that were refilled too soon. On May 1, 2024, Reject–79 Refill Too Soon and Reject-79 Refill Too Soon Carryover were returned to normal functioning.  

• Read more about Skin Substitutes no Longer Require a Prior Authorization (PA) - CR 126315

Effective August 1, 2024, skin substitute products no longer require a PA. Providers are expected to select the most appropriate product for treatment and to use the products for the purposes for which they have FDA approval. 

For questions, please contact your Provider Relations Specialist.  

• Read more about Health PAS Online Portal – New: Member Renewal Date Now Available, CR 119276

In July 2024, MaineCare updated the Health PAS Online Portal to include the member’s renewal date, when available, so that providers can more accurately assess the status of a member’s eligibility. Please note the following updates about the eligibility renewal date field:  The new field shows the renewal date of members whose date has been finalized.

• Read more about USDA to Distribute Oral Rabies Vaccine for Wildlife in Northern Maine

Annual bait distribution aims to reduce spread of disease among raccoons

• Read more about Registration is Open for the MaineCare 2024 Delivery System Reform (DSR) Forums

Registration is now open for MaineCare's DSR Annual Forums for:

• Accountable Communities (AC),
• Behavioral Health Homes (BHH),
• Community Care Teams (CCT) including Housing Outreach and Member Engagement (HOME) providers,
• MaineMOM,
• Opioid Health Homes (OHH), and
• Primary Care Plus (PCPlus) providers.    

MaineCare is offering two venue/date options this year. Both sessions will run from 9:00 AM to 4:00 PM. 

• Read more about Maine CDC Identifies West Nile Virus in Six Wild Birds

Maine people and visitors urged to take precautions against bites during active mosquito season

AUGUSTA--The Maine Center for Disease Control and Prevention (Maine CDC) announced today that six wild birds from multiple counties tested positive for West Nile virus (WNV). This is the earliest in the year that Maine CDC has found the mosquito-borne virus in birds.