• Read more about MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter Ch. III, Section 67, Principles of Reimbursement for Nursing Facilities

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes.  The MaineCare Benefits Manual is available on-line at the Secretary of State’s website. 

• Read more about Rate Determination Initiation Notice for Certified Community Behavioral Health Clinics (CCBHC): MaineCare Benefits Manual (MBM) Section to Be Determined 

This bulletin provides notice that the Department has initiated a Rate Determination Process* for CCBHCs and is in the final stages of procuring a vendor. There will be opportunities throughout this Rate Determination process for stakeholders to provide feedback and comment.     

• Read more about Electronic Visit Verification (EVV) Trainings and Forums

The federal deadline to implement the EVV requirements for Home Health providers delivering services under Section 40 and Hospice providers delivering services under Section 43 happened January 1, 2023.

This is the last weekly provider training notice. All trainings and forums are online via Microsoft Teams.

NOTE:  The Absorb training system has been updated to allow providers to register for trainings and/or forums more than once.

Training Topics

• Read more about Attention Section 45 Hospitals, Distinct Psychiatric and Substance Use Disorder (SUD) Units: Rate Determination Update

Last Fall, MaineCare initiated a rate determination for Section 45, Distinct Psychiatric and SUD units.

• Read more about Attention Providers of Section 107, Psychiatric Residential Treatment Facilities (PRTFs) – Presented Materials and Comment Period 

On June 15, 2023, MaineCare held an online public meeting to present draft rate models along with rationale for the recommended rate models for Section 107, PRTFs.

• Read more about Service Locator Tool – Invitation to Behavioral Health Providers

The Department of Health and Human Services (DHHS) is excited to announce the creation of a Service Locator Tool hosted on Bamboo Health’s TreatmentConnection.com. The Tool will improve access to treatment for substance use and mental health issues. The goal is to publicly launch this tool in summer 2023. 

• Read more about Extended Release Buprenorphine (XRB) Clinical Use Criteria

In order to promote access to Sublocade, XRB, MaineCare may engage in rulemaking. In the meantime, providers may bill the medical benefit for XRB without prior authorization if their documentation meets the criteria outlined below. The criteria will be available on the Preferred Drug List after the July 2023 update. Failure to meet these criteria could result in sanctions.  

MaineCare Extended-Release Buprenorphine Clinical Criteria    

Jun 6, 2023

New data indicate that a Department of Health and Human Services (DHHS) initiative to fund recruitment and retention bonuses for direct support workers (DSWs) helped stabilize and grow Maine’s Home and Community Based Services (HCBS) workforce.

HCBS DSWs assist Maine people of all ages with physical disabilities, intellectual and developmental disabilities, and mental or behavioral health conditions. Their work is central to keeping people in their homes and communities while providing accessible, high-quality services to help them stay healthy and fulfil their personal goals.

• Read more about Bonuses Help Stabilize and Grow Maine’s Home and Community Based Service Workforce

• Read more about Guidance for Psychiatric Hospitals Seeking Prior Authorization (PA) for Mental Health Intensive Outpatient Services​

Psychiatric Hospital providers seeking to bill for Mental Health Intensive Outpatient (MH-IOP) Services under MaineCare Benefits Manual (MBM) Ch. II, Section 46.05-3 will be asked to submit PA requests through Atrezzo. Acentra Health (formerly Kepro) will review these requests in accordance with the substantive standards for MH-IOP services adopted in the November 9, 2022, revision of MBM Ch. II, Section 65 (Behavioral Health Services).

• Read more about MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter I, Section 4, Telehealth Services

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes.  The MaineCare Benefits Manual is available on-line at the