Electronic Visit Verification (EVV) Phase 2 Trainings
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
Revalidate with MaineCare to Avoid Claim Denials
The Affordable Care Act (ACA), Section 6401, states that almost all provider types must revalidate their information with MaineCare every five years. Durable Medical Equipment (DME) providers are required to revalidate their information with MaineCare every three years. The current round of revalidations began in January 2022.
The Nicotine Replacement Therapy (NRT) Standing Order National Provider Identifier (NPI) has been Updated
The NRT standing order can be accessed on the MaineCare website Providers Resources page, under Pharmacy. Please use NPI 1407110893 as the prescriber NPI on the claim. This NPI is only to be used for MaineCare members and submission of the MaineCare voucher.
Attention Primary Care Plus (PCPlus) Practices: Reminder - PCPlus Open Office Hour
The Delivery System Reform Unit (DSRU) will hold a PCPlus Open Office Hour on Tuesday, August 15, 2023, at 12:00 PM. The purpose of the Open Office Hour is to provide an accessible online venue for PCPlus providers to ask MaineCare's DSRU questions you have regarding the PCPlus program.
New: MaineCare New Coverage Groups Communications Toolkit
Please help us reach groups in your community who are newly eligible for MaineCare coverage as of July 1, 2022, with or without proof of citizenship:
*CORRECTED* State Fiscal Year (SFY) 2024 Rate Letters for Residential Care Facilities (RCFs, PNMI Appendix C), CR 119444
The SFY2024 rates for Residential Care Facilities that we calculated for the July 1, 2023 rate letters and implemented on August 9, 2023, by error did not include the direct care and routine cost adjustments.
10-144 C.M.R. 332; MaineCare Eligibility Manual, Parts 2, 3, 4, 5 and Chart 7; Rule #301 - Certain MAGI and CHIP Coverage Group Changes
This adopted rule provides continuing MaineCare coverage for parents, of children in the custody of the Office of Child and Family Services (OCFS), who are actively participating in family reunification. It also removes exclusions, lock-out periods, and premiums for Cub Care and increased the Federal Poverty Level (FPL) to 208% for all children. The adopted rule changes increase access to health insurance coverage.
10-144 C.M.R. Ch. 609 SNAP Employment and Training, Rule #6 - Name Change and Other Clarifications
The adopted rule updates the program name and references to the Supplemental Nutrition Assistance Program Employment and Training Program (SNAP E&T) from FSET to reflect recent updates for the SNAP program. The adopted rule is consistent with Maine revised statutes pursuant to P.L. 2021 c. 398 Part OO.
The adopted rule clarifies federal requirements for case management and job retention services and other minor updates made to clarify wording. Each of these updates more closely aligns the rule with 7 C.F.R. Section 273.3.
RESCHEDULED: Draft Rate Model Public Review and Comment for Providers of Section 97, Private Non-Medical Institutions (PNMI), Appendix D, Therapeutic Foster Care (TFC) Services
In June of 2023, MaineCare provided notice that it had initiated a rate determination for Section 97, PNMI Appendix D, TFC Services. The Office of Child and Family Services in collaboration with the Office of MaineCare Services has revised the service model to inform the development of the draft rates.