• Read more about Targeted Case Management (TCM) Services Provided by Section 9, Indian Health Services (IHS)

Effective December 15, 2023, providers enrolled under Section 9 of the MaineCare Benefits Manual (MBM) may provide TCM Services to eligible MaineCare members. IHS providers must comply with all requirements set forth in MBM, Section 13 TCM including those regarding member eligibility, record keeping, and covered services. IHS providers are not required to hold a mental health license to provide TCM Services.

• Read more about 340B Program Overview

MaineCare does not allow contract or retail pharmacies to enroll in the 340B Medicaid drug program, either directly or under subcontract with a 340B entity. MaineCare is Fee For Service (FFS).

All 340B providers who submit claims to MaineCare must determine whether they will use 340B drugs for their MaineCare patients (carve-in to the program) or whether they will purchase drugs for these patients through other mechanisms (carve-out of the program).

• Read more about The American Society of Addiction Medicine (ASAM) 4th Edition Release

The ASAM Criteria, nationally recognized as the gold standard in treatment assessment, was first developed in 1990. A new edition, The ASAM Criteria 4th edition, was released in December 2023, with subsequent volumes including:

• Read more about MaineCare Notice of Agency Rule-making Proposal, Chapters II and III, Section 23, Developmental and Behavioral Health Clinic Services

Notice of Agency Rule-making Proposal

AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Ch. 101, Chapters II and III, Section 23, Developmental and Behavioral Health Clinic Services

PROPOSED RULE NUMBER:

CONCISE SUMMARY:

• Read more about Reminder: Home and Community Based Services (HCBS) Compliance Form Instructions for Waiver Services Provider

The State requires all providers who deliver services under Sections 18, 20, 21, and 29 fill out a HCBS Compliance Form. Providers delivering HCBS services under the above sections of policy who are submitting new, revalidating, reactivating, and maintenance cases must fill out the form and upload it before the case can be finalized. This will ensure that providers of HCBS waiver services are in compliance with applicable requirements for HCBS waiver settings.

• Read more about Training Opportunity Available for Section 19 Home and Community Based Services for Older and Disabled Adult Caregivers

The Office of Aging and Disability Services is excited to announce a virtual training opportunity scheduled for Monday, February 26, 2024 - Mental Health First Aid. This training is being provided under collaboration with the National Alliance on Mental Illness (NAMI) Maine and is available for caregivers providing services to Section 19 members. Caregivers can include personal support staff, attendants, home health aides, nurses or other natural and family supports.

• Read more about CoverME.gov Finishes Open Enrollment with Many New Consumers Covered This Year

More than 62,500 Maine consumers enrolled in affordable coverage for 2024

• Read more about Issue Corrected: Attention Section 67 Providers – Members Coverage Inadvertently End-Dated in MIHMS

On January 8, 2024, we announced to Section 67 Nursing Facilities (NFs) providers that several members had their MaineCare coverage for NF Services inadvertently end-dated on December 31, 2023. This issue is now corrected, and providers can submit their claims for dates of service from January 1, 2024, to present. 

• Read more about Updated January 1, 2023, Behavioral Health Rate Adjustments FAQs Regarding Assertive Community Treatment (ACT)

Upon reassessment, the Office of MaineCare Services determined it has sufficient flexibility in policy language to require ACT providers to maintain a panel-wide average of three contacts per member, in alignment with fidelity to the model, rather than delivering a minimum monthly average for each member of three contacts per week. In accordance with MBM Section 17.04-3, in the event a member does not receive three contacts in a week, providers must continue to document why.

• Read more about SNAP Rule #229A - Electronic Benefit Theft

Pursuant to the Consolidated Appropriations Act 2023 (CAA 2023), Public Law 117-328, Division HH, Title IV § 501, EBT Benefit Fraud Prevention requirements, the Department adopts changes to the SNAP Manual, Section 777-4 to align with the requirements of the CAA 2023. The adopted rule changes provide clarity on the Department’s procedure and timeframes for replacement of SNAP benefits determined to have been stolen through card skimming, card cloning, or similar fraudulent methods. The U.S.D.A.