• Read more about Attention Providers of Section 21 Home Support Agency Per Diem: Enforcement Discretion Related to Reimbursement for Asleep Staff 

The Department recently adopted amendments to Section 21 rules (10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 21). The rules clarified longstanding policy related to overnight staff in group homes.

• Read more about Attention Home Health and Hospice Service Providers: July 1, 2022 EVV Soft Launch Implementation and MaineCare Member Letter

Home Health Soft Launch

This message is another reminder about the Electronic Visit Verification (EVV) “soft launch” period for providers of section 40 Home Health and section 43 Hospice services ahead of the January 1, 2023 federal implementation deadline that was originally announced August 13, 2021.

• Read more about Attention Providers of Section 18, 19, 20, 21, and 29 Services: Appendix K to Maine’s Home and Community Based Waivers Continues to Provide Temporary Flexibilities on Service Caps, Staffing

Appendix K to Maine’s Home and Community-Based Services 1915(c) waivers provides the state certain flexibilities in waiver program operations during an emergency. Maine’s Appendix K and amendments may be found here. 

• Read more about Attention Behavioral Health Service Providers - Behavioral Health and Targeted Case Management Supplemental Payment Information 

Per PL 2021, ch. 635, Sec.

• Read more about EPSDT Coverage for Children’s Residential Care Facility Level of Care

In certain exceptional and high-risk situations for youth under the age of 21, the Office of MaineCare Services (OMS) will approve a MaineCare member’s clinical eligibility for services in a Children’s Residential Care Facility (CRCF) under the Early Periodic Screening Diagnostic and Treatment (EPSDT) benefit, MaineCare Benefits Manual (MBM) Chapter II, Section 94, without requiring an attempt to use a lower level of care. 

• Read more about EPSDT Coverage for Children’s Residential Care Facility Level of Care​

In certain exceptional and high-risk situations for youth under the age of 21, the Office of MaineCare Services (OMS) will approve a MaineCare member’s clinical eligibility for services in a Children’s Residential Care Facility (CRCF) under the Early Periodic Screening Diagnostic and Treatment (EPSDT) benefit, MaineCare Benefits Manual (MBM) Chapter II, Section 94, without requiring an attempt to use a lower level of care. 

• Read more about Reminder for Providers Billing on UB-04 and 837I Claims, CR 107682

Effective June 30, 2022, UB-04 and 837I claims submitted without an attending provider will be denied.

• Read more about Electronic Visit Verification (EVV) Web Browser Notice

Effective Monday, July, 18, 2022, Sandata will update their web browser security requirements. Users accessing the Sandata EVV and Aggregator portal on or after July 18^th must use up-to-date web browsers to access these tools.

• Read more about CORRECTION: COVID-19 Vaccine Counseling Under the American Rescue Plan, CR 109388 – PLEASE HOLD ON SUBMITTING CODES

This is a follow-up to the message we sent on June 13, 2022. Please hold on submitting claims for COVID-19 vaccine counseling until further notice. 

• Read more about MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder

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