Jul 7, 2022

The Office of MaineCare Services has launched Primary Care Plus (PCPlus), a new initiative to support primary health care, advance health care quality, and improve the efficiency of health care spending. PCPlus enables MaineCare to replace the prior outdated and convoluted system of payments and offer primary care practices a single, integrated process for reimbursement with greater flexibility and incentives to meet MaineCare members’ health care needs. 

• Read more about MaineCare Launches New Payment Model to Improve Primary Care Services

• Read more about Drug Rate Updates

Additional 2021 Drug Rate Updates, CR 106867 

On January 12, 2022, we updated certain drug code rates retroactively to either January 1, 2021, or July 1, 2021, in MIHMS based on updates from the Centers for Medicare & Medicaid Services (CMS).  

• Read more about Rate Update for 2022 Ambulatory Surgical Centers (ASC) Rates, CR 107519 

On February 10, 2022, as part of a regular annual update, we updated the rates for MaineCare Benefits Manual, Chapter II, Section 4, Ambulatory Surgical Center Services, in MIHMS retroactively to January 1, 2022.  

• Read more about MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 25 (repeal); Chapter III, Section 25 (repeal) and Chapter II, Section 25, Dental Services and Reimbursement Methodology (replaces the two repealed rules)

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed

• Read more about Office of Aging and Disability Services Virtual Listening Session to Access Technology for Individuals with Intellectual and Developmental Disabilities 

The Department of Health and Human Services (DHHS) Office of Aging and Disability Services (OADS) is hosting a virtual listening session to gather input on Supporting Access to Technology by Individuals with Intellectual and Developmental Disabilities (IDD).

• Read more about Alternate Electronic Visit Verification (Alt EVV) Specification Requirement 

We published an updated Alternate Electronic Visit Verification Specification document on the Health PAS Online Portal, called “EVV Requirement Specification.” This document is for providers using an alternate/third-party vendor to meet EVV requirements.  

• Read more about Attention Specialty Providers: Primary Care Plus (PCPlus) Impact on Referrals  

Effective July 1, 2022, Primary Care Plus (PCPlus) is MaineCare’s new value-based approach to support the primary care system, improve healthcare quality, and reduce inefficient health care spending. PCPlus replaces MaineCare’s former primary care programs, including Primary Care Case Management (PCCM), Primary Care Provider Incentive Payment (PCPIP), and primary care Health Homes, with a single, integrated initiative.

• Read more about Announcement: Seeking provider participants for new telehealth pilot 

Background  

In June 2021, the Maine Department of Health and Human Services (DHHS) received $32 million grant funding through a National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities.

• Read more about Clone of PSS Instructors

• Read more about Re-entry Update #9

July 15, 2022

Good morning, 

It is halfway through July which is a good time for me to remind supervisors to process your workers’ DHHS Telework Approval Forms. The deadline to finish this work is two weeks from today.

So far, 2,620 forms have been submitted with 1,821 approved: we have 25 percent left for review. Supervisors may also be working on adjustments to telework to balance space, office coverage, etc. As such, workers may be asked resubmit forms to get them approved.