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On June 29, 2023, the Centers for Medicare and Medicaid Services (CMS) announced the new POS code 27, that will be effective October 1, 2023. This POS code is for services that are provided on the street to people who are unhoused or experiencing homelessness.
We regret to inform you that the public review and comment forum that was scheduled for September 8, 2023, to present the draft rates and service model for TFC services, has been postponed for a second time.
The Department has adopted routine technical rule changes that amend Chapter 264, Immunization Requirements for Healthcare Workers, by removing COVID-19 from the list of vaccine preventable diseases for which Designated Healthcare Facility employees must show proof of immunization or provide appropriate exemption documentation. Public comments were considered prior to adopting the final rule. The adopted rule is consistent with the proposed rule published for public comment on July 19, 2023.
The Department is proposing the repeal of three existing licensing rules and replacing those rules with one single rule, Behavioral Health Organizations Licensing Rule, to provide a comprehensive, one-stop licensing rule. This proposed rule governs the licensing requirements for mental health and substance use disorder treatment programs. The rules proposed for repeal and replacement include community and residential licensing standards for mental health and substance use disorder treatment services.
MaineCare has identified a claim processing error. MaineCare is the payor of last resort. Providers are required to bill the primary vision insurance before billing MaineCare. Vision service codes have been paying as MaineCare primary when the Member has an active primary vision insurance carrier that has not been billed. MaineCare will reprocess claims with overpaid services and recoup the overpayment. No provider action is needed.
The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.
We continue to offer weekly provider and aggregator trainings. All trainings are online via Microsoft Teams.
NOTE: The Absorb training system has been updated to allow providers to register for trainings more than once.
EVV Training Schedule
Upon further review, MaineCare is increasing the final proposed rates for NDPP sessions and performance payments from 72.4% to 100% of Medicare.
Effective August 19, 2023, we have made the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates in MIHMS.
The following CMS document provides the details of the APC updates:
July 2023 Integrated Outpatient Code Editor Specs:
Sessions are ongoing, in-person at your location, customized to your needs, and with flexible schedules.
Subjects include:
The adopted rule incorporates the Able-Bodied Adult Without Dependents (ABAWD) work requirements in Section 111-7 pursuant to the Fiscal Responsibility Act of 2023 (FRA) and consistent with 7 U.S.C.