DHHS → node
In June of 2023, the Office of MaineCare Services initiated a rate determination for Section 45, Hospital Services with the goal of incentivizing quality care and cost effectiveness and updating an outdated reimbursement methodology.
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 application using the Apple Store, or Google Play. The current version of the app is now being phased out, effective September 4, 2024. To avoid any interruption of visit record keeping, you should now download the latest version of the app.
Please contact Provider Services with questions:
As an update to previous communication, the implementation of Section 17 COLA rates effective January 1, 2024, has been delayed. These new rates will be implemented for billing on August 14, 2024. We apologize for any inconvenience.
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 45, Hospital Services
As previously shared in our June 4, 2024, bulletin, the Department has initiated a rate determination process for certain services provided under Sections 12, 18, 19, 20, 21, 29, 40, 96, & 102 of the MaineCare Benefits Manual.
This notice amends that initiation to include Personal Support Services in this rate determination.
Aug 8, 2024
Maine's Medicaid program (MaineCare) is in the midst of significant changes that make it more important than ever to keep Maine people covered for health care. Following the end of the COVID-19 Public Health Emergency, updates to federal rules mean that every Mainer who has coverage through MaineCare will have their coverage reviewed to ensure they are still eligible -- this process is known as the "unwinding" of the continuous Medicaid eligibility requirement. This process started in April 2023, and eligibility redeterminations will be completed by October 31, 2024.
The purpose of the rulemaking is to clarify the application process for Developmental Services available at OADS that are supported exclusively with state funds. The rule also removes descriptions of internal agency processes regarding client intake and eligibility determination, updates the tests for determining whether an applicant has an intellectual disability (abandoning the harmful terminology of years past) and Autism Spectrum Disorder, and identifies the state-funded Developmental Disability Services available from OADS.
The previous e-message announcing the implementation of COLAs for Section 92, BHH, has been corrected to display the accurate effective date of December 21, 2023.
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).
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.”