Date posted:
Attachment(s):
Notice of MaineCare Reimbursement Methodology Change
AGENCY: Department of Health and Human Services, Office of MaineCare Services
SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Sections 45 and 46, Psychiatric Hospital Services
NATURE OF PROPOSED CHANGES: The Department plans to submit a state plan amendment (SPA) to the Centers for Medicare & Medicaid Services (CMS) to request approval to provide supplemental payments to eligible hospitals beginning November 2025. These payments will be made twice annually, in November and May. Eligible hospitals are those that are enrolled in the Maine Medicaid program as private psychiatric hospitals and delivering services in the quarter preceding each payment. The annual supplemental payment will total $4,299,687 in fiscal year 2026 and will total $2,866,458 in fiscal years 2027 and beyond. This supplemental payment will be distributed to each eligible hospital based on their relative share of MaineCare payments identified on MaineCare cost reports for state fiscal year 2022. These payments will not be subject to cost settlement.
REASON FOR PROPOSED CHANGES: All changes are pursuant to Maine P.L. 2025, Ch. 388 - An Act Making Unified Appropriations and Allocations from the General Fund and Other Funds for the Expenditures of State Government and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2025, June 30, 2026 and June 30, 2027
ESTIMATE OF ANY EXPECTED INCREASE OR DECREASE IN ANNUAL AGGREGATE EXPENDITURES: The Department anticipates that this change will result in an increase of $4,299,687 in federal fiscal year 2026 which includes $2,635,278 in federal funds and $1,664,409 in state funds, and will cost $2,866,458 in federal fiscal year 2027 which includes $1,735,927 in federal funds and $1,130,531 in state funds.
ACCESS TO PROPOSED CHANGES AND COMMENTS TO PROPOSED CHANGES: The public may review the proposed methodology changes and written comments at any Maine DHHS office in every Maine county. To find out where the Maine DHHS offices are located, call 1-800-452-1926.
CONTACT INFORMATION
FOR RECEIPT OF COMMENTS: Kristin Merrill
AGENCY NAME: Office of MaineCare Services
ADDRESS: 109 Capitol Street, 11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: (207) 624-4006 FAX: (207) 287-6106
TTY: 711 Maine Relay (Deaf or Hard of Hearing)
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
State Plan Amendment
Office: MaineCare Services
Email: Kristin.Merrill@maine.gov
Comment deadline:
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