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.  

Maine Achieves Record High Immunization Rates for School Children

Annual survey shows over 95 percent of children attending public and private schools have received required vaccines

AUGUSTA– The Maine Center for Disease Control and Prevention (Maine CDC) announced today that more than 95 percent of school-age children have received all required vaccines, the first year Maine has exceeded the “herd immunity” threshold since reporting began in 2011.

New Health Home Model for Substance Use Disorders (SUDs) – Rate Study Kickoff Meeting

As previously shared in our December 8, 2023, bulletin, the Department initiated a rate determination for a new Health Home Model for other SUDs. As a result of that process, we are now conducting a rate study.  

You are receiving this email because we are inviting you to participate in the rate study process for this service.  

Maine Department of Health and Human Services Supplemental Budget Summary

Apr 4, 2024

The supplemental budget passed by the Legislature and signed by Governor Mills on Monday invests in a range of Maine Department of Health and Human Services programs and initiatives. This includes mental health and substance use disorder prevention and response, violence prevention and recovery, child health and welfare, MaineCare payment reform, and maintaining core services.

Attention Pharmacy Providers: Service Restoration Office Hours with MaineCare Pharmacy Benefit​

MaineCare is inviting you to join the next Office Hours call with the MaineCare Pharmacy team on Thursday, April 25, 2024, from 09:00 AM – 9:45 AM related to the initial restoration of Maine Point of Purchase System (MEPOPS). We will use this time as an opportunity for sharing questions and concerns and providing technical support from the State.  

Please register in advance for this meeting: 

Attaching an Explanation of Benefits (EOB) to Secondary Claims

When billing MaineCare secondary claims, you must attach an EOBA to all claims regardless of the submission type listed below:

  • Direct Data Entry (DDE)
  • Paper
  • Electronic Data Interchange (EDI)

When submitting electronically, upload the EOB once the claim is in MIHMS. The charges billed on the claim lines must match the charges billed on the EOB, or the claim will be denied.

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