Justice Initiatives

The mission of the Maine Department of Health and Human Services (DHHS) is to provide health and human services to the people of Maine so that all persons may achieve and maintain their optimal level of health and their full potential for economic independence and personal development.

The Office of Maine Care has taken broad steps to fulfill DHHS’s mission through new Justice Initiatives, which is comprised of 3 Parts.

State Fiscal Year (SFY) 2025 Rate Letters for Section 67, Nursing Facilities (NFs) and Section 97, Appendix C, Residential Care Facilities (RCFs)

MaineCare will increase reimbursement rates for certain services under Sections 67 NFs and 97, Appendix C, RCFs effective July 1, 2024, through a Cost-of-Living Adjustment (COLA), in alignment with MRS Title 22, 3173-J (referred to as ‘Rate Reform Statute’). The COLA is equal to an increase of 4.91% above the currently established rate(s), which is based on the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index for nursing homes and adult day care services as required under Maine P.L. 2017, ch. 460 (see 22 MRSA §1708, sub-§3, ¶F for NFs).

Section 97, Private Non-Medical Institutions (PNMI) Appendix F: Rate Letters for Fiscal Year (FY) 2025, CR 125612

The Section 97, Appendix F, FY 2025 rate letters will be accessible on the secure Health PAS Online Portal by July 1, 2024. To view them, log into your Trading Partner Account and follow this pathway: File Exchange > Reports > Rate Setting Letters.    

If you have questions about accessing the letters, please contact Provider Services at: 1-866-690-5585.     

For questions about the content of these letters, please contact Rate Setting directly by using the contact listed on each letter.  

Section 50, Intermediate Care Facilities (ICF) Rate Letters for Fiscal Year (FY) 2025 Now Available, CR 125576

The FY 2025 Section 50 ICF rate letters are now available on the secure Health PAS Online Portal. To view them, log into your Trading Partner Account and follow this pathway: Exchange > Reports > Rate Setting Letters.    

If you have questions about accessing the letters, please contact Provider Services at: 1-866-690-5585.     

For questions on the content of these letters, please contact Rate Setting directly by using the contact listed on each letter.

MaineCare Issued Annual Hospital Value-Based Purchasing (VBP) Supplemental Payments and Correction to Previous Results

Earlier this month, MaineCare issued supplemental payments to nine hospitals rewarding the high levels of primary care utilization for MaineCare members in their Hospital Service Areas (HSAs). The table below shows how the top eight HSAs, which include nine hospitals, surpassed the statewide average of 57.5% MaineCare members within the HSA with a primary care visit in 2023. This sub-pool, totaling $600,000 annually, supports hospitals that partner with a MaineCare Accountable Community.

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