DHHS → node
As communicated on February 23, 2024, Change Healthcare is experiencing a network interruption related to a cyber security issue. This is a national issue affecting health care systems and Medicaid programs in many states, including Maine.
MaineCare increased reimbursement rates for certain services through a cost-of-living adjustment (COLA) as directed by 22 MRSA Section 3173-J and 22 MRSA Section 7402, as enacted by Maine P.L. 2021, ch. 398, Part AAAA. The COLA is effective as of January 1, 2024, and is equal to an increase of 2.54% above the currently established rate(s).
NPIs, i.e. Pay To, Rendering, and Non-Billing, Ordering, Prescribing, and Referring (NOPRs) are now checked against the National Plan and Provider Enumeration System (NPPES) directory to see if there is a match. If there is not a match, the NPI will not be allowed entry. Providers should review the information entered to ensure accuracy. If the system still will not accept the NPI, providers should wait at least five business days and try again.
The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.
We continue to offer weekly EVV 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
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EVV Phase 2 Training and Aggregator Content – State and Provider Trainings |
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This 30-minute live webinar will cover updates from Maine State Housing Authority and the MaineCare Housing Outreach and Member Engagement (HOME) programs. A recording will be posted on MaineCare’s website. Register for the webinar. We look forward to seeing you there!
Please contact Emily Bean with questions.
EVV Providers who are currently using the SMC app through their phone, tablet, or other mobile device should update to the latest version of the app using the Apple Store, or Google Play. The current version of the app is being phased out as of July 1, 2024. To avoid any interruption of visit record keeping, you should now download the app that has a version number of 3.0 or higher.
Please contact Provider Services with questions:
Plans to temporarily pay independent and safety-net pharmacies to support MaineCare members' access to medications in response to Change Healthcare outage
AUGUSTA– The Department of Health and Human Services (DHHS) announced today that it has developed an interim payment system for independent and safety net pharmacies in response to the continued disruption of the pharmacy claims system for MaineCare, Maine’s Medicaid program.
The Department of Health and Human Services (DHHS) will be issuing interim payments for independent and safety net pharmacies in response to the continued disruption of MaineCare’s pharmacy claims due to the cybersecurity issue affecting Change Healthcare. For previous communications about this issue, see the February 27, 2024 e-message here.
This notice is to alert you that MaineCare will be providing support to help pharmacy providers verify member eligibility over the weekend on March 2 and 3, 2024. You can call Gainwell Provider Services’ Interactive Voice Response (IVR) phone line to verify member eligibility for pharmacy claims.
You can call Gainwell Provider Services’ Interactive Voice Response (IVR) phone line to verify member eligibility for pharmacy claims. You will need your pharmacy’s National Provider Identify (NPI) and the member’s MaineCare ID number. Call 1-866-690-5585 and press or say the number 1. The automated system will prompt you through the call. The system will respond best when responses are keyed into the keypad instead of announced verbally.
Instructions
Call 1-866-690-5585.
Select or say 1.