Jun 6, 2025

The recently passed FFY 2025 budget reconciliation bill (the "One Big Beautiful Bill Act") contains significant Medicaid (MaineCare) policy changes, including a mandatory work requirement provision for Medicaid expansion members and the removal of good faith waivers for Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC) audits with error results above a certain low threshold. This document provides an overview of the potential impacts to Maine's Medicaid program.

• Read more about Additional Impacts to Maine Medicaid (MaineCare) from Proposed Federal Changes

• Read more about Child Care Affordability Program Rules, 10-148 C.M.R. Ch. 6

This emergency routine technical rulemaking is necessary to comply with Federal Rule updates according to 42 U.S.C. 9858 et seq., 45  C.F.R. Pt. 98, which makes multiple changes to the payment structure of the Child Care Affordability Program, including:

• Read more about Child Care Affordability Program Rules, 10-148 C.M.R. Ch. 6

This routine/technical rulemaking is necessary to comply with Federal Rule updates according to 42 U.S.C. 9858 et seq., 45  C.F.R. Pt. 98. The Department adopted the changes outlined below on an emergency basis on 5/19/25, and this proposed rulemaking will adopt these changes before the emergency rule expires on 8/17/25 at 11:59pm EST (U.S. and Canada). This rulemaking proposes to promulgate on a non-emergency basis changes to the payment structure of the Child Care Affordability Program, including:

• Read more about Billing Reminder: When Services are Rendered Via Telehealth

All MaineCare services delivered via Telehealth must comply with Ch I, Section 4 of the MaineCare Benefits Manual (MBM). Unless otherwise specified, all services must be billed in accordance with applicable sections of the MBM. Providers must also submit claims in accordance with Department billing instructions.

• Read more about Video test

• Read more about Maine Celebrates Record High Immunization Rates Among School Children; Prepares for Statewide Implementation of Docket for Schools

Annual survey shows over 97 percent of children attending Maine's public and private schools have received required vaccines

AUGUSTA-- The Maine Department of Health and Human Services' Maine Center for Disease Control and Prevention (Maine CDC) announced today that more than 97 percent of school-age children have received all required vaccines, the second consecutive year that Maine has exceeded the "herd immunity" threshold since reporting began in 2011.

• Read more about Licensing Requirements for ​Intensive Outpatient Program (IOP) Providers

This notice provides joint guidance from the Office of MaineCare Services and the Division of Licensing and Certification (DLC). 

Providers delivering IOP services covered under Chapter II, Section 65, Behavioral Health Services, must be licensed by the DLC under 10-144 C.M.R. Ch. 123 to deliver medication management because IOP services include medication management, as needed, in accordance with 65.05-5(A)(2)(d). 

As a result, to be appropriately licensed to deliver IOP services, the following applies: 

• Read more about Section 92, Behavioral Health Homes (BHH) Cost-of-Living Adjustments (COLA)

As we communicated yesterday, we are increasing reimbursement rates for some services that we originally planned to implement for January 1, 2025 through a COLA.  

Effective June 21, 2025, Section 92 services will receive this increase, to align with the regular billing cycle. This rate adjustment is equal to an increase of 1.95% above the current rates.  

• Read more about ​2025 Home and Community Based Services (HCBS) Consumer Assessment of Healthcare Providers & Systems (CAHPS®) Survey​

The State of Maine Department of Health and Human Services aims to improve HCBS. We would like to hear about Medicaid beneficiary experiences with waiver services. For the third consecutive year, the State of Maine’s Office of Aging and Disability Services (OADS) is completing the CAHPS® HCBS survey. Knowledge Services, a survey vendor, will again assist the State with survey administration.  

• Read more about MaineCare Cost of Living Adjustments (COLAs) for Sections 12, 13, 17, 18, 19, 20, 21, 26, 28, 29, 65, 92, 96, and 97C

MaineCare is increasing reimbursement rates through a COLA for certain services that were originally scheduled for January 1, 2025. This COLA is provided in accordance with PL 2025 Ch. 2. The intent of this COLA is to increase reimbursement for direct care workers and help ensure the continuation of essential MaineCare services. The COLA will be effective July 1, 2025, and is equal to an increase of 1.95% above the currently established rates.