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.

Facility Licenses Under Title 5

Providers whose facility license is under a Title 5 review may use their Title 5 notice to extend their enrollment with MaineCare in MIHMS by six months, and for every six months thereafter, until the Title 5 review is resolved. Providers must complete this update by submitting a maintenance case via the Health PAS Online Portal. Providers can utilize the Provider Maintenance User Guide for a step-by-step guide for submitting a Title 5 Maintenance Case.

Annual 1115 Substance Use Disorder (SUD) Waiver Post Award Forum

On December 22, 2020, Maine DHHS announced the Center’s for Medicare & Medicaid Services (CMSs) approval of MaineCare’s waiver request, which lifts the federal restriction for residential or inpatient SUD treatment programs beyond 16 beds. The Implementation Plan was approved on July 26, 2021, which allows MaineCare to begin collecting federal funds for residential treatment facilities that expand their capacity.

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