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MaineCare implemented a Biosimilar Preferred Drug List (PDL) this past May that establishes preferred and non-preferred Physician-Administered Drugs (PADs). Preferred drugs are available without a Prior Authorization (PA), and non-preferred drugs require a PA.
MaineCare now requires accurate certification information for Type 92 providers prior to approval for that provider type. The certification consists of an approval letter from the Maine Department of Education that indicates the approval period.
The Department has posted Rate Letters for State Fiscal Year 2023 for Nursing Facilities (NFs) and Residential Care Facilities (RCFs, PNMI Appendix C) to the Health PAS Online Portal, and the rates have been loaded into MIHMS. Details about the timing of these rates were announced in a prior bulletin on August 31, 2022.
On September 23, 2022, the Department adopted Section 25, Dental Services and Reimbursement Methodology, which is effective beginning today, September 28, 2022. This rule makes the following changes to covered service limits, prior authorization (PA) requirements, and rate changes that differ from the emergency Section 25 rule that has been in effect since July 1, 2022.
Covered Service Changes
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the propose
This bulletin provides notice that the Department has initiated a Rate Determination Process* for Section 31: Federally Qualified Health Center Services of the MaineCare Benefits Manual. The Department is conducting this rate determination pursuant to Public Law 2022, Chapter 747.
This bulletin provides notice that the Department initiated a Rate Determination Process* for Section 60: Medical Supplies and Durable Medical Equipment of the MaineCare Benefits Manual prior to P.L. 2022 Ch. 639 becoming effective. The Department is conducting this rate determination pursuant to P.L. 2021, Ch. 398, Sec.