Rate Determination Initiation Notice for Section 30 – Family Planning Services

This bulletin provides notice that the Department has initiated a Rate Determination Process* for Section 30 – Family Planning Services of the MaineCare Benefits Manual. The Department is conducting this rate determination. The newly determined rates will provide reimbursement under MaineCare that will better align with a team based, patient-centered approach to integrated care.  

Electronic Visit Verification (EVV) Implementation Tips

The federal deadline to implement the EVV requirements for Home Health providers delivering services under Section 40 and Hospice providers delivering services under Section 43 is January 1, 2023.  

The following tips are designed to help providers’ EVV claims process in a timely manner. 

Three-Day Recycle Period 

Home Health and Hospice service claims with dates of service beginning on July 1, 2022, are subject to an EVV claim pend edit, unless a verified EVV record is found.

Maine DHHS Releases Recipients of Nearly $74 Million in Child Care Stabilization Grants

Nov 11, 2022

The Maine Department of Health and Human Services today published a comprehensive compilation of child care providers in the state that received nearly $74 million in COVID-19 Child Care Stabilization Grants, which helped Maine child care providers increase pay for staff and cover costs related to COVID-19.

Attention Providers of Section 65, Crisis Residential and Resolution Services: Draft Rate Model Public Review and Comment 

Earlier this fall MaineCare conducted a survey of Section 65 Crisis Residential and Resolution Services providers. We used the provider responses, in addition to other information, to create draft rate models for the services as part of the rate determination process. We outlined this process during our kick-off meeting with providers on May 12, 2022. This message outlines the next steps in the process related to draft rate models for the current Crisis Residential and Resolution services.

Temporary Occupancy Penalty Waiver for Nursing Facility Providers

The Office of MaineCare Services is temporarily waiving the minimum occupancy penalty for nursing facilities, found in Chapter III, Section 67, principle 18.9, through the end of the federal Public Health Emergency (PHE). The waiver applies to facilities with at least one month of service delivery under the PHE, starting with fiscal year ending June 30, 2020. 

Electronic Visit Verification (EVV): Weekly Billers of Home Health and Hospice services and EVV Training and Forms

In preparation for EVV editing, providers must ensure billing software is configured to have individual dates of service on separate claim lines so they match up with a verified EVV record when claims are submitted as a batch file into the Health PAS Online Portal. 

Electronic Visit Verification (EVV) Trainings and Forums

The federal deadline to implement the EVV requirements for Home Health providers delivering services under Section 40 and Hospice providers delivering services under Section 43 is January 1, 2023.  

With these EVV deadlines quickly approaching, we continue to offer weekly provider and aggregator trainings and forums. All trainings and forums are online via Microsoft Teams. 

MaineCare Recognized as National Leader in Medicaid Innovation for Rate System Reform

Nov 11, 2022

The Maine Department of Health and Human Services is pleased to share that the Office of MaineCare Services (OMS) was recognized today by the National Association of Medicaid Directors (NAMD) for its work to transform Maine’s rate-setting system to better support the health of members and sustainability of providers.

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