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At the beginning of the COVID-19 pandemic, the federal government relaxed certain requirements to promote continued access to healthcare services for members enrolled in Medicaid. ARPA enabled MaineCare to cover through September 30, 2024, certain COVID-19 related services which were otherwise not covered under the MaineCare Benefits Manual (MBM).
At the beginning of the COVID-19 pandemic, the federal government relaxed certain requirements to promote continued access to healthcare services for members enrolled in Medicaid. ARPA allows states to cover COVID-19 vaccination, testing, and treatment without member cost sharing through September 30, 2024.
Beginning on October 1, 2024, MaineCare will reinstate copayments (copays) which had been waived for certain services.
Reinstated Copayments
As previously noticed, MaineCare and its vendor are hosting several engagement sessions with interested parties to obtain important feedback as part of the rate determination process that was initiated in June of 2024, for certain HCBS services.
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.
Notice of Agency Rule-making Adoption
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R, Chapter 101, Chapter II, Section 25, Dental Services and Reimbursement Methodology
ADOPTED RULE NUMBER:
CONCISE SUMMARY:
Maine people and visitors urged to protect themselves during high-risk mosquito season
AUGUSTA-- The Maine Center for Disease Control and Prevention (Maine CDC) announced today four wild birds tested positive for West Nile virus (WNV) in three new counties -- Piscataquis, Sagadahoc, and Washington. An alpaca also tested positive for WNV in Lincoln County, where a prior case of WNV was detected in a bird earlier this summer.
Effective September 14, 2024, the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates are complete in MIHMS. The following CMS documents provide the details of the APC updates:
https://www.cms.gov/files/document/r12666cp.pdf
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. The taxonomy is also used by CMS to conduct program oversight, administration, and integrity.
OCFS contracts with KEPRO to manage Children’s Residential Care Facility Services (CRCF). Children’s Residential Care Facility Services for children follows the MaineCare Section 97 eligibility criteria. KEPRO processes all applications and completes Prior Authorizations for Children’s Residential Care Facility Services, and they are your contact related to approval for admissions to Children’s Residential Care Facility.
The adoption of Maine’s Amyotrophic Lateral Sclerosis Incidence Registry Rule, a new rule administered by the Maine Center for Disease Control and Prevention, establishes data collection requirements and data release protocols specific to reportable cases of patients diagnosed with amyotrophic lateral sclerosis (ALS). For the purpose of the statewide ALS registry required by 22 MRS Sec.