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In June 2023, MaineCare provided notice that it initiated a rate determination for Section 45, Hospital Services, pursuant to the principles and processes under PL 2021, ch.639, An Act to Codify MaineCare Rate System Reform.  
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
On November 20, 2023, MaineCare held an online public meeting with its vendor Manatt Health Strategies, LLC., to present the recommended draft Family Planning APM, along with rationales. Stakeholders were able to provide public comment during this forum.
In an e-message on July 10, 2023, the Department alerted providers about coverage reinstatement for certain MaineCare members. MaineCare transitioned some individuals who were no longer eligible for full coverage to a Medicare Savings Plan (MSP) under federal guidance.
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed ru
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed ru
The Office of Aging and Disability Services (OADS) is currently divided into two Chapters: 10-149 (formerly the Office of Elder Services) and 14-197 (formerly the Office of Adults with Cognitive and Physical Disability Services). OADS is completing the process of combining these two former State agencies into one by eliminating use of 14-197 and creating a single comprehensive OADS Policy Manual under 10-149. This rulemaking repeals the current 10-149 Chapter 1 and replaces is with 10-149, Chapter 2, Section 1: Adult Protective Services System. The rule also co
MaineCare’s Secondary Billing Instructions have been updated to reflect the following.
When billing MaineCare secondary claims, you must attach an Explanation of Benefits (EOB) to all claims regardless of submission type:
When submitting electronically, you will need to upload the EOB once the claim is in MIHMS. The charges billed on claim lines must match the charges billed on the EOB, or the claim will be denied.
The Office of Aging and Disability Services is excited to announce a virtual training opportunity entitled Mental Health First Aid, scheduled for Monday, December 11, 2023. This training is provided under collaboration with the National Alliance on Mental Illness (NAMI) Maine and is available for caregivers providing care to Section 19 members. Caregivers can include personal support staff, attendants, home health aides, nurses or other natural and family supports.
This is a reminder that the attending provider is required on all UB-04 and 837I claims. MaineCare denies UB-04 and 837I claims submitted without an enrolled attending provider.