835 and RA Delays
835 and Remittance Advice (RA) processing is delayed. We are working to correct the issue as quickly as possible. We apologize for the inconvenience.
Re-entry Update #11
Good morning,
We are now in the fourth phase of the Department’s re-entry process, which is about preparation. This includes preparing offices to have more workers in them.
To that end, we are moving ahead with the installation of sit-stand desks in offices. We expect many of them will be installed by September. We are working on the schedule to install the remainder in early fall. We hope you enjoy them.
CLARIFICATION regarding Sections 13, 17, 28, 65, 92 Draft Rate Model(s) Public Review and Comment message
This message is to clarify an announcement last week regarding three online public meetings MaineCare is holding the week of September 19 to present draft rate models for Sections 13, 17, 28, 65, and 92.
Pfizer and Moderna Bivalent COVID-19 Vaccines Authorized to use as Booster Doses
In an August 31, 2022, announcement, the Food and Drug Administration (FDA) issued Emergency Use Authorizations (EUA) for the use of Bivalent COVID-19 Vaccines from Pfizer BioN-Tech and Moderna as a Booster Dose.
Tribal Self-Attestation, CR 108474
Effective August 26, 2022, the Department is now allowing MaineCare members to self-attest to being members of federally recognized tribes for the purpose of waving copayments and premiums.
ATTENTION Section 92, Section 13, and Section 17 Providers: Passthrough process now required if organizations jointly serve an Opioid Health Home (OHH) Member
Please see changes below that apply when a Section 92 Behavioral Health Home, Section 13 Targeted Case Management, or Section 17 Community Integration provider delivers services to members enrolled with an Opioid Health Home (OHH).
Attention Providers of Sections 13, 17, 28, 65, 92 Draft Rate Model(s) Public Review and Comment
Earlier this year MaineCare conducted a survey of Behavioral Health and Other Services providers. We used the provider responses to create draft rate models for the services as part of the rate determination process. We outlined this process in a bulletin on April 22, 2022. This message outlines the next step in the process.
PUBLIC REVIEW AND COMMENT
Division of Audit Appeal Decisions
Note: The first step in the appeal process is an informal review by the Division of Audit. Those decisions are posted here. The next step in the appeal process would be an administrative hearing before the Hearings Unit. The Recommended and Final Hearing Decisions are available at the Administrative Hearings Unit’s Provider Appeal Decisions’ section of their webpage.
Re-entry Update #12
Good morning and happy September.
Tuesday, September 6 is the official start of the new DHHS Telework Policy. We are excited to welcome many of you back to our offices. We want to use this opportunity to update you on several “hot topics.”
Department Statistics: Over 2,100 workers have approved DHHS Telework Policy forms, including workers who choose not to telework.