Billing Guidance to Include National Drug Codes (NDCs) in Drug Claim Lines
When submitting drug claims, please bill your usual and customary charge for the drug and populate it in the charge field of the claim.
Removing Custom Fee Schedules from the HealthPAS Online Portal, CR 115784
Today, May 8, 2023, MaineCare removed custom fee schedules for chiropractor, optometry, podiatry, and home health services and incontinence supplies from the HealthPAS Online Portal.
Update to the Biosimilar Preferred Drug List
On April 21, 2023, we updated Biosimilar Preferred Drug List (PDL) on the Health PAS Online Portal.
Attention all Providers: Payment Error Rate Measurement (PERM) Audit
The State of Maine is currently in the process of a federally mandated PERM audit for Reporting Year 2024. This audit covers randomly selected paid claims with a payment date from July 1, 2022, through June 30, 2023. Due to the random sampling of claims, all providers should be prepared to send requested medical records (more information below) to support claims that were or will be paid during this time period.
Maine CDC Marks Lyme Disease Awareness Month with “Tick Free ME” Tips
AUGUSTA – The Maine Center for Disease Control and Prevention (Maine CDC) urges Maine residents and visitors to take precautions to stay “tick free” during Lyme Disease Awareness Month (PDF) this May.
Pfizer-BioNTech COVID-19 Bivalent Vaccine Booster Authorized for Use in Individuals Aged Six Months to Four Years, CR 116564
On March 28, 2023, we sent an announcement that we will cover the Pfizer-BioNTech bivalent COVID-19 vaccine booster for individuals ages six months to four years as outlined in the Emergency Use Authorization (EUA) form the
Delivery System Reform Unit (DSRU) Virtual Update Session
MaineCare’s DRSU is holding a virtual learning session about MaineCare’s strategy for delivery system and rate reform, along with updates on other important initiatives. This session is open to all providers. This session is on May 22, 2023, from 1:30 to 3:00 PM.
Maine CDC Identifies Positive Measles Test Result
Notifies facilities where exposure may have occurred out of an abundance of caution pending confirmation
AUGUSTA, Maine— The Maine Center for Disease Control and Prevention (Maine CDC) has received a report of a positive measles laboratory result in a Maine child and is awaiting confirmation from the U.S. Centers for Disease Control and Prevention (U.S. CDC). The Maine CDC notified the facilities where exposure may have occurred and is working with those facilities to inform potentially exposed individuals.
PMP Newsletter - March 2023
New Features
The Maine Prescription Monitoring Program is excited to announce that it has launched new, online waiver request processes for prescribers and dispensers.
Prescribers can now request waivers from the Electronic Prescribing mandate online. Once logged into the Maine PMP at maine.pmpaware.net, click on Menu, under the Waivers heading, click on Individual Request for E-Prescribing Waiver. This new process makes it significantly easier to request a waiver and speeds up the approval process.
MaineCare Updates: Preparing for the End of the Public Health Emergency (PHE)
At the beginning of the COVID-19 pandemic, the federal government declared a PHE and relaxed certain requirements to ensure Medicaid members could continue to access healthcare services. The federal government has declared that the PHE will end on May 11, 2023.
Starting May 12, 2023, some billing flexibilities and how MaineCare members access health care services will revert to how they were administered prior to the declaration of the PHE.