• Read more about 10-144 C.M.R. Ch. 333; Low Cost Drugs for the Elderly and Disabled (DEL) Manual; MC Rule #305P - DEL Asset Test Removal

The proposed rule change would remove the asset test, Section 2.1, effective retroactive to January 1, 2024. The proposed rule change is based on a legislative change to 22 M.R.S. § 254-D(4)(B) made by P.L. 2023, ch. 412, Part EEEEE. This rule change is consistent with a recent MaineCare Eligibility Manual proposed rule change which would remove the asset test for all Medicare Savings Plan coverage types. Retroactive rulemaking is permissible under 22 M.R.S.

• Read more about 10-144 C.M.R. Ch. 301; Supplemental Nutrition Assistance Program (SNAP) Rules; Section 999-3; Rule #231A - FFY24 Budgeting Changes

Maine exercises an option for Broad Based Categorical Eligibility under 7 C.F.R. § 273.2(j)(2) which includes a 200% Federal Poverty Level (FPL) test.

• Read more about MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual Chapter II, Section 89

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

• Read more about MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual Chapter II, Section 89

Notice of Agency Rule-making Adoption

AGENCY: Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 89, MaineMOM Services and Reimbursement

ADOPTED RULE NUMBER:

CONCISE SUMMARY:  

• Read more about Electronic Visit Verification (EVV) Phase 2 Trainings

The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.

We continue to offer weekly provider and aggregator trainings. All trainings are online via Microsoft Teams.

NOTE:  The Absorb training system has been updated to allow providers to register for trainings more than once.

EVV Training Schedule

• Read more about MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter II, Section 89

Notice of Agency Rule-making Adoption

AGENCY: Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 89, MaineMOM Services and Reimbursement

ADOPTED RULE NUMBER:

CONCISE SUMMARY:  

• Read more about COVID-19 Therapeutics Transition to Commercial Market, and UPDATE on COVID-19 Vaccine Coverage

In a letter released October 27, 2023, the U.S. Department of Health and Human Services (HHS) announced the plan to transition two COVID-19 oral therapeutics from government supplied to the commercial market. The transition process started on November 1, 2023, for Paxlovid manufactured by Pfizer and Lagevrio, manufactured by Merck.  

• Read more about MaineCare Gender Affirming Care Coverage Guide Now Available

In order to ensure MaineCare members get the health care services they need, and have the information necessary to make informed decisions, MaineCare has created a new Gender Affirming Care Coverage Guide. This guide helps answer member’s questions about what MaineCare covers and offers helpful links to find providers who offer this care.

• Read more about Attention Providers of Section 25, Dental Services: Kickoff Meeting Presented Materials

As previously shared in our October 13, 2023, bulletin, the Department has initiated a rate determination process for Dental Services. We are rebasing the existing benchmarks so that they reflect the most recent data for the payer source.  

• Read more about Rate Determination Initiation Notice for Section 3, Primary Care Plus (PCPlus) Phase Two

This bulletin provides notice that the Department has initiated a Rate Determination Process* for PCPlus services and is in the final stages of procuring a vendor. This is a rate determination to establish a more advanced alternative payment model for primary care services and supports, including the incorporation of Community Health Worker (CHW) team members and social risk adjustment. This work will be referred to as PCPlus “Phase Two.”