MaineCare Cost Report Template

*Attention Nursing Facility Providers who received a supplemental payment on 09/05/2024. The following schedule GG is necessary for the Providers utilizing the funds for expenses incurred during fiscal year 12/31/2023. *

NF Sch GG-LTC Supplemental Payment #4 Reconciliation.xlsx

Please note that our checklist has been updated and needs to be used for all submissions going forward.

The cost report needs to be submitted in Microsoft Excel format.  We will no longer accept locked or protected cost report files or files that have hidden tabs.

Cost reports and supporting documentation should be filed using FileZilla, our secure file transfer program.  If you have not established an account with us yet to be able to securely transfer files, please reach out to Lucas Allen, Manager of Data Analytics, at lucas.allen@maine.gov.  As a reminder submission of files need to follow specific requirements:  each filename will need to contain the facility name, 4-digit year the document relates to, and what the document is (i.e. cost report); files cannot be zipped; files cannot be password protected or restricted in any way (i.e. we need to be able to print extract, or stamp/markup all PDF documents); and files need to be in one of the following formats:  Microsoft product or Adobe PDF to ensure machine readable.

If your cost report identifies an amount due to the State, checks should now be sent separate from the cost report signature page and directly to the DHHS Financial Service Center A/R, 109 Capitol Street, 1^st Floor, 11 State House Station, Augusta, ME 04333-0011.  When sending the check also include a copy of the settlement page(s) and any offset paperwork.

If you have any issues downloading the cost reports please contact Lucas Allen, Manager of Data Analytics at Lucas.Allen@maine.govor (207) 287-2831.