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All MaineCare Providers are required to update any change in their enrollment within 10 days of the change per Chapter I, Section 1.03-1(B) of the MaineCare Benefits Manual (MBM). These updates can be but are not limited to:
Effective July 1, 2024, the Critical Access Hospital (CAH) swing bed rate and Nursing Facility (NF) days awaiting placement (DAP) rates have been recalculated for State Fiscal Year 2025. You can view both related memos on the rate setting page of the Health PAS online portal.
Notice of Agency Emergency Rule-making Adoption
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE:
10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 45, Principles of Reimbursement for Hospital Services
ADOPTED RULE NUMBER:
CONCISE SUMMARY:
EMERGENCY RULE
Notice of Agency Rule-making Adoption
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE:
10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 45, Principles of Reimbursement for Hospital Services
ADOPTED RULE NUMBER:
CONCISE SUMMARY:
EMERGENCY RULE
This message is an update to a previous communication regarding the implementation of Section 17 COLA rates effective January 1, 2024. Implementation of these rates is delayed until August 14, 2024. We apologize for any inconvenience.
In June of 2023, the Office of MaineCare Services initiated a rate determination for Section 45, Hospital Services with the goal of incentivizing quality care and cost effectiveness and updating an outdated reimbursement methodology.
EVV Providers who are currently using the SMC app through their phone, tablet, or other mobile device should update to the latest version of the application using the Apple Store, or Google Play. The current version of the app is now being phased out, effective September 4, 2024. To avoid any interruption of visit record keeping, you should now download the latest version of the app.
Please contact Provider Services with questions:
As an update to previous communication, the implementation of Section 17 COLA rates effective January 1, 2024, has been delayed. These new rates will be implemented for billing on August 14, 2024. We apologize for any inconvenience.
Notice of MaineCare Reimbursement Methodology Change
AGENCY: Department of Health and Human Services, Office of MaineCare Services
SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Section 45, Hospital Services
As previously shared in our June 4, 2024, bulletin, the Department has initiated a rate determination process for certain services provided under Sections 12, 18, 19, 20, 21, 29, 40, 96, & 102 of the MaineCare Benefits Manual.
This notice amends that initiation to include Personal Support Services in this rate determination.