DHHS → node
The Office of MaineCare Services (OMS) is currently accepting Prior Authorization (PA) requests for coverage of palivizumab due to the increasing trend of positive RSV tests. The clinical benefit of palivizumab therapy is best realized by timing the administration to coincide with the peak of RSV activity.
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.
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 (MBM), Chapter II, Section 71, National Diabetes Prevention Program
ADOPTED RULE NUMBER:
CONCISE SUMMARY:
Department also launches dedicated web page with resources for health providers
AUGUSTA— The Maine Department of Health and Human Services (DHHS) announced today that it is deploying volunteer health care personnel through Maine Responds, Maine’s health volunteer system, to provide behavioral health support and staff respite support to Central Maine Medical Center (CMMC) in Lewiston following last Wednesday’s tragedy.
In the coming weeks, MaineCare will update the administration fee for the 2023-2024 commercial COVID-19 vaccines to $39.11, to align with Medicare reimbursements. This change will be retroactive to September 11, 2023.
The Office of MaineCare Services implemented a systems enhancement to automate updates to the licensure of rendering providers. Historically, providers have needed to submit a maintenance case to update the license expiration date for their already enrolled rendering providers. MaineCare’s MIHMS system will now automatically update a MaineCare-enrolled rendering provider’s license expiration date against the State of Maine’s Agency License Management System (ALMS).
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 I, Section 4, Telehealth Services
ADOPTED RULE NUMBER:
CONCISE SUMMARY:
This adopted rule makes the following changes:
12/13/2023
As previously shared in our October 16, 2023 provider bulletin, certain Appendix K flexibilities for sections 18, 21, and 29 will continue beyond November 11, 2023. MaineCare expects the Centers for Medicare & Medicaid Services (CMS) to approve the corresponding 1915(c) waiver amendments necessary to make these changes permanent in the coming months.
As previously shared in our October 16, 2023 provider bulletin, certain Appendix K flexibilities for sections 18, 21, and 29 will continue beyond November 11, 2023. MaineCare expects the Centers for Medicare & Medicaid Services (CMS) to approve the corresponding 1915(c) waiver amendments necessary to make these changes permanent in the coming months.