• Read more about Taxonomy Code Requested on Claim Submissions – Portal Claims

The Office of MaineCare Services (OMS) is requesting that providers include the taxonomy code on all claims. The taxonomy code is necessary for the Centers for Medicaid and Medicare Services (CMS) to collect data for Transformed Medicaid Statistical Information System (T-MSIS) reporting. This data helps to inform states of their current standing in data quality as compared to other states and is crucial for research and policy on Medicaid and CHIP. The taxonomy is also used by  CMS to conduct program oversight, administration, and integrity.  

• Read more about Rules Governing Self-Contained Breath Alcohol Testing Equipment 10-144 CMR Ch. 269

The Department is proposing this routine technical rulemaking following the adoption of amendments by emergency rulemaking effective May 28, 2024, that qualified the use of a dry gas standard under 10-144 CMR chapter 269 - Rules Governing Self-Contained Breath Alcohol Testing Equipment. The Department is ensuring that the dry gas standard provisions added for calibrating units in the emergency rule do not expire on August 26, 2024, with the emergency rule (5 MRS 8054(3)).

• Read more about Paragraphs Test

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• Read more about Justice Initiatives

The mission of the Maine Department of Health and Human Services (DHHS) is to provide health and human services to the people of Maine so that all persons may achieve and maintain their optimal level of health and their full potential for economic independence and personal development.

The Office of Maine Care has taken broad steps to fulfill DHHS’s mission through new Justice Initiatives, which is comprised of 3 Parts.

• Read more about State Fiscal Year (SFY) 2025 Rate Letters for Section 67, Nursing Facilities (NFs) and Section 97, Appendix C, Residential Care Facilities (RCFs)

MaineCare will increase reimbursement rates for certain services under Sections 67 NFs and 97, Appendix C, RCFs effective July 1, 2024, through a Cost-of-Living Adjustment (COLA), in alignment with MRS Title 22, 3173-J (referred to as ‘Rate Reform Statute’). The COLA is equal to an increase of 4.91% above the currently established rate(s), which is based on the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index for nursing homes and adult day care services as required under Maine P.L. 2017, ch. 460 (see 22 MRSA §1708, sub-§3, ¶F for NFs).

• Read more about Section 97, Private Non-Medical Institutions (PNMI) Appendix F: Rate Letters for Fiscal Year (FY) 2025, CR 125612

The Section 97, Appendix F, FY 2025 rate letters will be accessible on the secure Health PAS Online Portal by July 1, 2024. To view them, log into your Trading Partner Account and follow this pathway: File Exchange > Reports > Rate Setting Letters.    

If you have questions about accessing the letters, please contact Provider Services at: 1-866-690-5585.     

For questions about the content of these letters, please contact Rate Setting directly by using the contact listed on each letter.  

• Read more about Section 50, Intermediate Care Facilities (ICF) Rate Letters for Fiscal Year (FY) 2025 Now Available, CR 125576

The FY 2025 Section 50 ICF rate letters are now available on the secure Health PAS Online Portal. To view them, log into your Trading Partner Account and follow this pathway: Exchange > Reports > Rate Setting Letters.    

If you have questions about accessing the letters, please contact Provider Services at: 1-866-690-5585.     

For questions on the content of these letters, please contact Rate Setting directly by using the contact listed on each letter.

• Read more about Maine Breast & Cervical Health Program (MBCHP) Code & Rate Update for Fiscal Year (FY) 2025

In coordination with the National Breast & Cervical Cancer Early Detection Program and the Centers for Medicaid Services (CMS), the MBCHP has updated the approved codes and rates effective July 1, 2024.

• Read more about Attention Section 55, Laboratory Services: January 1, 2024, Rate Update, CR 124692

Effective January 1, 2024, MaineCare has updated the Section 55 rates shown below. These new rates were implemented for billing on June 6, 2024. The full fee schedule can be viewed on the Rate Setting page of the Health PAS Online Portal.

• Read more about MaineCare Issued Annual Hospital Value-Based Purchasing (VBP) Supplemental Payments and Correction to Previous Results

Earlier this month, MaineCare issued supplemental payments to nine hospitals rewarding the high levels of primary care utilization for MaineCare members in their Hospital Service Areas (HSAs). The table below shows how the top eight HSAs, which include nine hospitals, surpassed the statewide average of 57.5% MaineCare members within the HSA with a primary care visit in 2023. This sub-pool, totaling $600,000 annually, supports hospitals that partner with a MaineCare Accountable Community.