• Read more about 10-144 CMR Ch. 123, Behavioral Health Organizations Licensing Rule

The Department is proposing the repeal of three existing licensing rules and replacing those rules with one single rule, Behavioral Health Organizations Licensing Rule, to provide a comprehensive, one-stop licensing rule. This proposed rule governs the licensing requirements for mental health and substance use disorder treatment programs. The rules proposed for repeal and replacement include community and residential licensing standards for mental health and substance use disorder treatment services.

• Read more about Add Codes to the TPL Vision Services Group, CR 119556

MaineCare has identified a claim processing error. MaineCare is the payor of last resort. Providers are required to bill the primary vision insurance before billing MaineCare. Vision service codes have been paying as MaineCare primary when the Member has an active primary vision insurance carrier that has not been billed. MaineCare will reprocess claims with overpaid services and recoup the overpayment. No provider action is needed.  

• Read more about 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.

We continue to offer weekly 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

• Read more about Rate Update for the Proposed MaineCare Benefits Manual (MBM), Chapter II, Section 71: National Diabetes Prevention Program (NDPP) Services

Upon further review, MaineCare is increasing the final proposed rates for NDPP sessions and performance payments from 72.4% to 100% of Medicare.

• Read more about Microdyn Update for Ambulatory Payment Classifications (APCs), and Diagnostic Related Groups (DRG’s), CRs 119337, 119338, & 119340

Effective August 19, 2023, we have made the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates in MIHMS.        

The following CMS document provides the details of the APC updates:       

July 2023 Integrated Outpatient Code Editor Specs:     

• Read more about ​​Free Asthma Education Sessions for Maine Healthcare Professionals

Sessions are ongoing, in-person at your location, customized to your needs, and with flexible schedules.  ​   

​Subjects include:  

• Read more about 10-144 C.M.R. Ch. 301 Supplemental Nutrition Assistance Program (SNAP) Rule 228A - FRA 2023

The adopted rule incorporates the Able-Bodied Adult Without Dependents (ABAWD) work requirements in Section 111-7 pursuant to the Fiscal Responsibility Act of 2023 (FRA) and consistent with 7 U.S.C.

• Read more about Maine Career Ladder Income Mobility and Benefits (CLIMB) Tools and Training

About Maine CLIMB Tools

The Maine Department of Health and Human Services (DHHS) and the Department of Labor (DOL) are partnering with the Federal Reserve Bank of Atlanta to offer five groundbreaking tools that help individuals, employers, and policymakers understand how various career pathways can lead to economic mobility and stability, while also understanding the potential loss of public assistance based on income, career goals, and family dynamics.  

• Read more about MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 71, National Diabetes Prevention Program Services

Notice of Agency Rule-making Proposal

AGENCY:  Department of Health and Human Services, MaineCare Services, Division of Policy

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 71, National Diabetes Prevention Program Services

PROPOSED RULE NUMBER:

CONCISE SUMMARY: This proposed rulemaking seeks to make the following changes:

• Read more about Correction to Zoom Link - Attention: Listening Session for MaineCare Residential Substance Use Disorder (SUD) Providers

Effective July 1, 2023, Acentra Health (formerly Kepro) began reviewing residential SUD admissions for MaineCare members to assess appropriate American Society of Addiction Medicine (ASAM) level of care as one of the tasks associated with MaineCare’s 1115 SUD waiver.

The Department will hold a listening session to hear from impacted providers about the process to date. Please join us on September 22, 2023, from 10AM-11AM through Zoom.

Registration link: