• Read more about Non-Billing, Ordering, Prescribing, and Referring (NOPR) Edits Changing from Warn to Deny – CR 121469

Billing providers must include the National Provider Identifier (NPI) of an enrolled MaineCare practitioner who is ordering, prescribing, or referring on their claims to receive reimbursement for the categories of services listed below. These practitioners are known as NOPRs and must enroll in MaineCare independently or as part of an organization. 

This requirement is for all prescription claims (including Point of Sale claims) as well as claims for the following: 

• Read more about MaineCare Benefits Manual, Section 71, National Diabetes Prevention Program Services

• Read more about Survey Deadline Extended: Sections 18, 20, 21, 29 Home & Community Based Supports and Proposed Lifespan Waiver Cost Survey Tool

Due to the statewide disruption caused by the storm on December 18, 2023, the Department is extending the deadline to complete the service delivery and cost data survey to February 7, 2024, at 5:00 PM eastern time. The Department does not anticipate any further extensions to this deadline. 

• Read more about Maine DHHS Extends Deadline for SNAP Recipients to Apply for Help Replacing Food

Recipients now have until January 18 to apply for benefits to replace food lost as a result of Monday’s storm

AUGUSTA— The Maine Department of Health and Human Services (DHHS) announced today that Maine people who lost food purchased through the Supplemental Nutrition Assistance Program (SNAP) as a result of Monday’s storm now have until January 18, 2024, to apply for benefits to replace that food.

• Read more about Maine DHHS Encourages People to Take Advantage of Mental Health Help this Holiday Season

AUGUSTA - The Maine Department of Health and Human Services (DHHS) encourages Maine people to take advantage of the many resources available to support mental health during this holiday season and at the end of a challenging year for many.

• Read more about ​​Comment Deadline Extended: Private Non-Medical Institutions (PNMI) Appendix D, Therapeutic Foster Care (TFC) Draft Rate Model

MaineCare is extending the deadline for comments on the TFC draft rate model from December 20, 2023, to January 10, 2024. 

Please submit comments to Jessica Levesque, MaineCare’s Rate Reform Project Manager for TFC Services. 

• Read more about ​Attention Section 5, Ambulance Service Providers: 2024 Rate Updat

Effective January 1, 2024, MaineCare Benefits Manual, Section 5, Ambulance Service rates have been updated in MIHMS to reflect 100% of the most current Maine Medicare area 99 urban, rural, or super rural rate.

• Read more about ​Attention Providers of Sections 2, 13, 17, 26, 28, 65 and 92: Cost of Living Adjustment (COLA) Billing Guidance

MaineCare is providing the following billing guidance for sections that are eligible to receive a COLA but for which appropriations are pending. Please see our earlier December 1, 2023 notice for more details.  

• Read more about Certified Community Behavioral Health Clinic (CCBHC) Readiness Assessment - Initial Cohort Due Date of January 19, 2024

A goal of the Department of Health and Human Services (DHHS) is to identify a Maine model for CCBHC, reflecting the Department’s commitment to improving health care access and outcomes for people living in Maine, demonstrating cost-effective use of resources, and creating an environment where providers can innovate to deliver high-value care.

• Read more about Revalidate with MaineCare to Avoid Claim Denials

Per the Affordable Care Act (ACA), Section 6401, Durable Medical Equipment (DME) providers are required to revalidate your information with MaineCare every three years. The current round of revalidation began in January 2022.