MaineCare Cost of Living Adjustments (COLAs) Effective July 1, 2024

MaineCare is increasing reimbursement rates for certain services in the policy sections listed below, through a COLA as directed by MRS Title 22, §3173-J (referred to as ‘Rate Reform Statute’). The COLA will be effective July 1, 2024, and is equal to an increase of 2.54% above the currently established rate(s). This COLA increase is proportional to the percentage increase in the Maine minimum wage as determined by the Maine Department of Labor.

Attention Section 45, Hospital Distinct Psychiatric and Distinct Substance Use Disorder (SUD) Units: July 2024 Cost of Living Adjustment (COLA) Updates

MaineCare is increasing the per-diem base rates for Section 45, distinct psychiatric and distinct SUD units, as directed by MRS Title 22, §3173-J (referred to as ‘Rate Reform Statute’). The increase will be effective July 1, 2024. This increase is calculated by using inflation provided by the economic trend factor from the most recent addition of the “Healthcare Cost Review” from IHS Markit. 

Recoupment of Claim Payments for Non-Covered Services Processed Under the COVID-19 Uninsured Benefit After the End of the Federal Public Health Emergency (PHE)

As explained in the January 17, 2024, e-message, MaineCare’s COVID-19 Uninsured Benefit was available for uninsured individuals through the end of the federal PHE, which ended May 11, 2023. MaineCare will not pay for services for this population for dates of service after May 11, 2023.  

Section 31, Federally Qualified Health Centers (FQHCs) Annual Cost of Living Adjustments (COLAs) Effective July 1, 2024

MaineCare is increasing reimbursement rates for Section 31, FQHCs through a COLA directed by MRS Title 22, §3173-J (referred to as ‘Rate Reform Statute’). The COLA will be effective July 1, 2024. New rates were calculated using the FQHC Market Basket percentage as published by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services as directed by MRS Title 22, §3174-V.

Section 23, Developmental and Behavioral Clinic Services: Child Abuse Evaluations, Comment Summary and Final Draft Rate

On May 13, 2024, the Office of MaineCare Services initiated a rate determination process* for Section 23, Child Abuse Evaluations. We held a virtual public forum on May 17, 2024, to present the draft rate model to interested parties and allowed for public comment.  Interested parties were able to submit written comments through May 21, 2024. 

SNAP Rule #233P - Lottery and Gambling Winnings

The proposed rule change would update Section 444-12 based on a legislative change to 22 M.R.S. § 3104(16) made by P.L. 2024, ch. 501. These changes align Maine law with the Code of Federal Regulations as it relates to disqualifications based on gambling or lottery winnings. Applying one standard instead of two clarifies requirements for recipients and the Department without having an adverse impact on program integrity.

SNAP Rule #225P - Overpayments during the PHE

This rule change would halt collection of SNAP overpayments that resulted from errors originating from March 1, 2020 through May 11, 2023, the end of the Federal Public Health Emergency related to CoViD-19 (the PHE), unless they were the result of an Intentional Program Violation (IPV) on the part of the household. The ongoing ramifications of the PHE dictate that Department staff focus their efforts on issuing the correct benefits going forward rather than devote time and effort to recouping benefits that were inadvertantly over paid during the PHE.

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