Aug 8, 2022

The Maine Department of Health and Human Services (DHHS) has implemented a slate of MaineCare rate changes that improve the health and well-being of patients but have been historically underfunded. These changes, which took effect July 1, 2022, include a $54 million investment into cost-effective services tied to Medicare reimbursement and cut across nine MaineCare service areas from physical and occupational therapy to primary care. These rate adjustments will be updated annually, maintaining alignment of MaineCare rates with federal Medicare rates.

• Read more about DHHS Implements $54 Million Investment in New MaineCare Rates

• Read more about MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapter II, Section 93, Opioid Health Home Services, and Chapter III, Section 93, Reimbursement for Opioid Health Home Services

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the propose

• Read more about Home and Community Based Services (HCBS) Innovation Grants Funding Opportunity 

The Maine Department of Health and Human Services is seeking applications for innovative pilot projects in alignment with Home and Community Based Services (HCBS) to promote greater opportunities for independence and integration in community life for HCBS waiver program members. The Department may award project grants of up to $500,000 to successful applicants. Applications are due by November 8, 2022.

• Read more about Rate Determination Initiation Notice for Section 26, Day Health Services

This e-message provides notice that the Department is initiating a Rate Determination Process* for Section 26 (Day Health Services) of the MaineCare Benefits Manual.  New rates are being determined pursuant to section AAAA-6 of Public Law 2021 Chapter 398, which requires that effective 1/1/23 “the labor portion of the reimbursement rates for essential support workers as defined in Title 22, section 7401, subsection 3 to equal at least 125% of the minimum wage.”  

• Read more about Rate Determination Initiation Notice for Section 2, Adult Family Care Services

This e-message provides notice that the Department is initiating a Rate Determination Process* for Section 2 (Adult Family Care Services) of the MaineCare Benefits Manual.  New rates are being determined pursuant to section AAAA-6 of Public Law 2021 Chapter 398, which requires that effective 1/1/23 “the labor portion of the reimbursement rates for essential support workers as defined in Title 22, section 7401, subsection 3 to equal at least 125% of the minimum wage.”  

• Read more about NF and RCF July 1, 2022 Rate Letters Delayed Until October 3, 2022 

We had previously announced that SFY23 rate letters for providers in Section 67 and Section 97, Appendix C would be delayed until September 1, 2022 due to the effort required for providers to submit wage data for Department analysis necessary to implement section AAAA-5 of the biennial budget, 2021 P.L. Ch.

• Read more about MaineCare Job Openings

MaineCare will now send notices of job opportunities periodically through our General, All Services e-message list. All positions are located in Augusta, Maine.

We are accepting applications for the following state positions:

MaineCare Policy Planner

Application Deadline: August 15, 2022

• Read more about Monkeypox Diagnostic Testing and Vaccines: Hold Claims

In a July 26, 2022, press release, the American Medical Association (AMA) announced new CPT codes related to Monkeypox diagnostic testing and vaccination.  

• Read more about Attention Section 97, Appendix D Children’s Residential Care Facility Services Providers

This message provides an update to the previous message about Kepro Prior Authorization (PA) process for Children’s Residential Care Facility (CRCF) transfer requests. 

• Read more about CORRECTION: Attention Provider Type 92 Early Childhood Providers, CR 71822

Please see we have corrected the first sentence below. In the message earlier today, we said this change impacts Section 92 providers, but it impacts Provider Type 92 providers. 
 
In the coming months, MaineCare will require accurate certification information for Provider Type 92 providers prior to approval of their enrollment case. Certification dates in the provider’s enrollment case should match the certification end-date to ensure claims are paid appropriately.