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As of March 15, 2023, MaineCare temporarily excluded hospice services from EVV requirements as a delayed enforcement of our approved State Plan requirements.
Providers whose facility license is under a Title 5 review may use their Title 5 notice to extend their enrollment with MaineCare in MIHMS by six months, and for every six months thereafter, until the Title 5 review is resolved. Providers must complete this update by submitting a maintenance case via the Health PAS Online Portal. Providers can utilize the Provider Maintenance User Guide for a step-by-step guide for submitting a Title 5 Maintenance Case.
On April 19, 2024, the Department updated the previously posted NF rate model Q&A document to provide additional clarifying information. Interested stakeholders are encouraged to review.
On December 22, 2020, Maine DHHS announced the Center’s for Medicare & Medicaid Services (CMSs) approval of MaineCare’s waiver request, which lifts the federal restriction for residential or inpatient SUD treatment programs beyond 16 beds. The Implementation Plan was approved on July 26, 2021, which allows MaineCare to begin collecting federal funds for residential treatment facilities that expand their capacity.
Gainwell continues to reduce the time it takes to complete their steps within the MaineCare enrollment process. Gainwell completed 559 enrollment cases in March and the average turnaround time for case completion was approximately 20 days. Case inventory was 578 at the end of March and the average system age of a case in inventory dropped to approximately 16.4 days old.
Additionally, to improve MaineCare enrollment, the Office of MaineCare Services (OMS) and Gainwell:
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed rules on fi
As a reminder, the PCPlus application period is currently open. The open application period runs through Friday, May 3, 2024.
On March 22, 2024, the Food and Drug Administration (FDA) issued EUA for Pemgarda for the prevention of COVID-19 for individuals aged 12 and up with moderate to severe immune compromise due to a medical condition or taking immunosuppressive medications or treatments. These individuals are unlikely to mount an adequate immune response to COVID-19 vaccines. Pemgarda is not a substitute for COVID-19 vaccinations.
Evergreen PAs, with the prefix “LTS” issued prior to March 16, 2024, were created with 17-character IDs. EDI claims submitted with those PAs were being denied with the “UM not found” edit because the EDI 837 file was developed with a maximum of 15 characters for PA IDs.
The Department implemented a fix for this issue, and the system was updated to reflect the changes on April 16, 2024.
Please note: The correct deadline for written comments is April 26, 2024.
Public Review & Comment