State Fiscal Year (SFY) 2025 Rate Letters for Section 67, Nursing Facilities (NFs) and Section 97, Appendix C, Residential Care Facilities (RCFs)

MaineCare will increase reimbursement rates for certain services under Sections 67 NFs and 97, Appendix C, RCFs effective July 1, 2024, through a Cost-of-Living Adjustment (COLA), in alignment with MRS Title 22, 3173-J (referred to as ‘Rate Reform Statute’). The COLA is equal to an increase of 4.91% above the currently established rate(s), which is based on the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index for nursing homes and adult day care services as required under Maine P.L. 2017, ch. 460 (see 22 MRSA §1708, sub-§3, ¶F for NFs).

Additionally, the rate adjustments for RCFs also include updates to use fixed costs from the latest audited cost reports.

MaineCare continues to provide an add-on rate, as needed, per the requirement under 22 M.R.S. §7402 to enable providers to cover labor costs for essential support workers of at least 125% of the minimum wage. This add-on has been recalculated to account for the new increased direct care rates. Since the direct care rate increase from the COLA also contributes to ensuring that the rate meets the 22 M.R.S. §7402 requirements, providers require a proportionally lower amount from the add-on, and will see a slight reduction in the add-on amount, accordingly.

The NF and RCF rate letters will be available soon. Please watch for a follow up message to confirm the exact date.

Nursing Facility Specialty Rates

The Department is also updating the interim prospective rates for Specialty NF’s effective July 1, 2024, based on the most recent as filed cost reports. These rate letters will be available for viewing on the secure Health PAS online portal by July 1, 2024.

For questions on rate letters, please contact Rate Setting directly by emailing Dwayne Parsons.

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