Licensing Requirements for ​Intensive Outpatient Program (IOP) Providers

This notice provides joint guidance from the Office of MaineCare Services and the Division of Licensing and Certification (DLC). 

Providers delivering IOP services covered under Chapter II, Section 65, Behavioral Health Services, must be licensed by the DLC under 10-144 C.M.R. Ch. 123 to deliver medication management because IOP services include medication management, as needed, in accordance with 65.05-5(A)(2)(d). 

As a result, to be appropriately licensed to deliver IOP services, the following applies: 

Section 92, Behavioral Health Homes (BHH) Cost-of-Living Adjustments (COLA)

As we communicated yesterday, we are increasing reimbursement rates for some services that we originally planned to implement for January 1, 2025 through a COLA.  

Effective June 21, 2025, Section 92 services will receive this increase, to align with the regular billing cycle. This rate adjustment is equal to an increase of 1.95% above the current rates.  

​2025 Home and Community Based Services (HCBS) Consumer Assessment of Healthcare Providers & Systems (CAHPS®) Survey​

The State of Maine Department of Health and Human Services aims to improve HCBS. We would like to hear about Medicaid beneficiary experiences with waiver services. For the third consecutive year, the State of Maine’s Office of Aging and Disability Services (OADS) is completing the CAHPS® HCBS survey. Knowledge Services, a survey vendor, will again assist the State with survey administration.  

MaineCare Cost of Living Adjustments (COLAs) for Sections 12, 13, 17, 18, 19, 20, 21, 26, 28, 29, 65, 92, 96, and 97C

MaineCare is increasing reimbursement rates through a COLA for certain services that were originally scheduled for January 1, 2025. This COLA is provided in accordance with PL 2025 Ch. 2. The intent of this COLA is to increase reimbursement for direct care workers and help ensure the continuation of essential MaineCare services. The COLA will be effective July 1, 2025, and is equal to an increase of 1.95% above the currently established rates. 

Control of Notifiable Diseases and Conditions Rule, 10-144 CMR Ch. 258

The Department is adopting routine technical rule changes to its rule to control specific notifiable communicable, occupational, and environmental diseases and conditions, as authorized by Maine law (22 MRS chapter 250). Amendments to this rule include adding COVID-19, Enterococcus resistant diseases, Hard Tick Relapsing Fever, Hepatitis C (acute and chronic), Mpox virus infection, PFAS serum test results and removing Rabies post-exposure prophylaxis from the notifiable diseases list, which aligns with US CDC’s priorities for state surveillance.

Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840

This is a reminder that the attending provider is required on all UB-04 and 837I claims. MaineCare denies UB-04 and 837I claims submitted without an enrolled attending provider.

The attending provider is the individual who has overall responsibility for the patient’s medical care and treatment reported in the claim/encounter. The attending provider requirement includes all claim submission methods (paper, HealthPAS Online Portal, or 837I).

Taxonomy Code Requested on Claim Submissions – Portal Claims

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.  

Provider Responsibility for Managing Users in my Health PAS Trading Partner Accounts (TPA)

It is important for your TPA administrator to actively manage your user accounts for the Health PAS Online Portal. To manage users, log into the administrator TPA and click on “Account Maintenance” and then “Manage Users.” Edit existing, deactivated or reactivated users by clicking on the row of the user you would like to manage. The Administrator of the account and users with a security role of “R7-User Management” are allowed to use these features. 

Safeguarding Public Health: What's at Stake for Maine Under the Proposed Federal Budget

May 5, 2025

The Maine Center for Disease Control and Prevention (Maine CDC) is heavily reliant on federal funding to carry out its mission to protect and promote the health and wellbeing of Maine people. Proposed cuts contemplated at the federal level could significantly reduce the state's capacity to address chronic diseases, environmental health threats, injury prevention, maternal and child health, investigate outbreaks and emergency preparedness -- areas that are essential to the well-being of Maine people.

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