MaineCare Launches Initial Restoration of Pharmacy Claims System

Pharmacies resume billing for MaineCare members' prescriptions, following vendor disruption

AUGUSTA– The Maine Department of Health and Human Services (DHHS) announced today that pharmacies have resumed billing MaineCare for members' prescriptions, following the disruption to its pharmacy claims system due to the national cyber security issue affecting Change Healthcare.

​Public Review Rescheduled: Section 25, Dental Service Providers Benchmarking Results and Draft Rates​​

The public review and comment forum that was scheduled for March 29, 2023, has been rescheduled to April 12, 2024. The Department requires additional time to ensure a clear and transparent presentation of the draft rates and methods. We appreciate your patience and apologize for any inconvenience.  

Taxonomy Code Requested on Claim Submissions – Portal Claims

The Office of MaineCare Services (OMS) is requesting that providers include the taxonomy code on all claims. The taxonomy code is necessary for the Centers for Medicaid and Medicare Services (CMS) to collect data for Transformed Medicaid Statistical Information System (T-MSIS) reporting. This data helps to inform states of their current standing in data quality as compared to other states and is crucial for research and policy on Medicaid and CHIP.  andThe taxonomy is also used by helping CMS to conduct program oversight, administration, and integrity.  

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.

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

EVV Phase 2 Training and Aggregator Content – State and Provider Trainings

 

Date

Comment Deadline Extended: Section 67, Nursing Facilities Draft Rate Methodology

MaineCare is extending the deadline for comments on the Nursing Facility draft rate methodologies, from March 25, 2024, to April 8, 2024.  

Please see our previous notice for more information on where and how to submit comments through our vendor. 

For questions on this process, please contact Dwayne Parsons, MaineCare’s Acting Manager of Rate Setting.  

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