Prescribing Providers Must Enroll in MaineCare
Beginning September 1, 2025, MaineCare will only pay for prescriptions that are from providers who are enrolled with MaineCare.
Sections 21 & 29: July 1, 2025, Cost-of-Living Adjustments (COLAs) Implemented
On July 2, 2025, we sent a notice stating that the implementation of the 1.95% COLA for several sections of policy was delayed.
Section 50, Intermediate Care Facilities (ICF) Rate Letters for Fiscal Year 2026 (FY26) and Day Habilitation Service Rate Update – CR 133180
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) Rate Letters
Section 97, Appendix C, Residential Care Facilities (RCFs): Implementation of Part AAAA Adjustment
On June 5, 2025, MaineCare announced we planned to increase reimbursement rates through a Cost-of-Living Adjustment (COLA) for certain services, effective July 1, 2025. For select providers, this increased the part AAAA add-on and is in addition to the 1% direct care adjustment that is pending a 90 day wait. See the July 3, 2025, announcement for those details.
10-144 C.M.R. Ch. 330; Ch. 330; Higher Opportunity for Pathways to Employment (HOPE) Program Rules; HOPE Rule 104A - Section 4: Dental Services Update
10-144 C.M.R. Ch. 330; Higher Opportunity for Pathways to Employment (HOPE) Rules
Section 4
HOPE Rule 104A - Dental Services Update
10-144 C.M.R. Ch. 301; Supplemental Nutrition Assistance Program (SNAP) Rules; Section 111-7; SNAP Rule #238A - ABAWD Update
10-144 C.M.R. Ch. 301; Supplemental Nutrition Assistance Program (SNAP) Rules
Section 111-7
SNAP Rule #238A - ABAWD Update
The adopted rule effectuates routine technical changes to 10-144 C.M.R. Chapter 301; Supplemental Nutrition Assistance Program (SNAP) Program Rules, Section 111-7, ensuring consistency with 7 C.F.R. § 273.24(c).
Primary Care Plus (PCPlus) Model Advancement Meeting
Please join us on Wednesday, July 16, 2025, to learn about, and provide feedback about the next phase of MaineCare’s PCPlus reform work. This session will be an opportunity for practices to provide feedback on your experiences and insights from participating in the PCPlus model. Your input will help shape the next phase of the PCPlus Alternative Payment Model (APM).
Discussion Topics:
Federal Budget Reconciliation Law Now in Effect: Impacts on MaineCare, SNAP & CoverME.gov
Jul 7, 2025
On July 4, H.R. 1 -- Budget Reconciliation was signed into law, enacting sweeping federal changes to Medicaid, nutrition assistance, and health insurance Marketplace programs. Many provisions take effect later this year or sometime between 2026--2028 and will fundamentally reshape -- and, in many cases, eliminate -- how many Maine people access health coverage and food supports.
Sections 18, 20 & 65: July 1, 2025, Cost-of-Living Adjustments (COLAs) Implemented
Last week, we sent a notice stating that the implementation of the 1.95% COLA for several sections of policy was delayed.
The following policy sections received the COLA update, and the rates are now available for billing.
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18 |
HCBS for Adults with Brain Injury |
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20 |
System Maintenance Complete and Provider Maintenance Cases Resume
Earlier today, we sent a notice stating providers were not able to submit Maintenance Cases in our enrollment system due to unplanned maintenance. The maintenance is complete, and you may resume regular operations.
If you have questions or concerns regarding this, please contact Kenneth Jamison, MaineCare Provider Enrollment Manager.