• Read more about Attention Section 60 and Section 109 Hearing Aid Providers: Binaural Hearing Billing and Prior Authorization (PA) Guidance Update

Effective November 15, 2025, MaineCare implemented a temporary process to support member access to hearing aids when a provider determines a member is clinically eligible for a binaural hearing aid, but the member only meets MaineCare Benefits Manual (MBM), Chapter II, Section 60: Durable Medical Equipment and Section 109: Speech and Hearing Services coverage criteria for a monaural hearin

• Read more about Updated Guidance: Provider Responsibility Regarding Third Party Liability and Secondary Billing

In a previous notice, the Office of MaineCare Services (OMS) reminded providers of their responsibility regarding third-party liability and secondary billing. Pursuant to MaineCare Benefits Manual (MBM) Ch. I Section 1.07-3(B), MaineCare is the payor of last resort.

• Read more about Elimination of Mailing Paper Remittance Advice (RA) and Reduction of Paper Checks, CR 132320

Paper RAs

Starting the week of December 22, 2025, the Office of MaineCare Services (OMS) will no longer mail paper RAs to providers. This is a cost-saving initiative for the Department. We encourage you to reference the electronic PDF versions of the RAs posted on the Health PAS Online Portal. Advantages of using the PDF version include easier member and claim searching and access to previous RAs.

• Read more about Disclosures of Organizational Change Reminder

If your organization is going through an organizational change, please contact Gainwell to receive guidance before beginning an enrollment/revalidation/re-enrollment application or maintenance case and prior to submitting the Disclosure of Organizational Change for MaineCare form. This allows Gainwell/MaineCare to review the change and decide what is the best way the provider needs to enroll or update their enrollment.

Please contact the MaineCare Enrollment email box with questions.  

• Read more about Seasonal Influenza Activity Increasing in Maine

It's not too late to vaccinate, take steps to prevent illness

AUGUSTA-- The Department of Health and Human Services' (DHHS') Maine Center for Disease Control and Prevention (Maine CDC) urges Mainers to take steps to protect their health as influenza (flu) activity begins to rise across Maine.

• Read more about Follow up Training Requirements for Children’s Behavioral Health Homes (BHHs) Coordinators and Children’s Targeted Case Managers

On December 15, 2025, we sent an e-message about all BHH Coordinators and Children’s Targeted Case Managers requirement to complete Wraparound Planning Principles (WPP) Training by January 31, 2026, as part of the Department of Justice Children’s Behavioral Health Services Settlement Agreement.

As follow up, please see the instructions for fulfill this requirement:

• Read more about 10-148 C.M.R. ch. 31; Quality Rating and Improvement System: Rising Stars for ME

On September 24, 2025, to comply with recent amendments to 22 M.R.S. § 3737(3), the Maine Department of Health and Human Services (Department) amended 10-148 C.M.R. ch.

• Read more about 10-144 CMR c. 261, Immunization Requirements for School Children

The Maine Center for Disease Control and Prevention within the Department of Health and Human Services is proposing this routine technical rule change jointly with the Maine Department of Education to amend Immunization Requirements for School Children rules. The proposed rule does not make any changes to required vaccinations but updates the vaccine schedule to provide additional guidance related to the minimum time required between vaccine doses and to enable students who “catch up” by completing required doses to be considered immunized under the rule.

• Read more about Updated Shell Case Guidance for Behavioral Health Providers

Acentra Health, in partnership with the Office of MaineCare Services (OMS), previously issued guidance on September 9, 2025 for providers to submit shell cases in Atrezzo for Acentra to determine whether a service for a child is medically necessary under ViatalCare for Kids (formerly EPSDT).  

• Read more about Raccoon in Wells Tests Positive for Rabies

Maine CDC seeks person with potential direct exposure

AUGUSTA-- The Maine Department of Health and Human Services' Maine Center for Disease Control and Prevention (Maine CDC) is asking anyone who touched a raccoon in Wells, Maine to call 1-800-821-5821.