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On February 26, 2025, we announced that, absent emergency action by the Legislature, the Department would need to temporarily hold certain provider payments beginning with the payment cycle that will run on March 12, 2025. As of the time of this message, the Legislature has not approved the necessary funding to avoid these measures.
On February 26, 2025, we announced that, absent emergency action by the Legislature, the Department would need to temporarily hold certain provider payments beginning with the payment cycle that will run on March 12, 2025. As of the time of this message, the Legislature has not approved the necessary funding to avoid these measures.
With the end of the COVID-19 public health emergency and Appendix K flexibilities, Section 21 Home Support- Agency Per Diem providers must follow service requirements outlined in the MaineCare Benefits Manual (MBM) regarding the number of members served. MBM Ch. II, Section 21.10-6 states "As of December 24, 2012, Home Support- Agency Per Diem placements will only be approved at provider-controlled homes where a minimum of two (2) Members reside.”
Please join us on March 28, 2025, for a PCPlus Program Reorientation Meeting on the following topics:
Date: March 28, 2025
Time: 12:00 to 1:00 PM
Registration link: Please register prior to the meeting.
See the Supplemental Billing Instructions on the Health PAS Online Portal which explains how to bill Inpatient Prospective Payment System (IPPS) services and Outpatient Prospective Payment System (OPPS) claims.
For questions, please contact Tiffany Norton, Provider Relations Specialist.
See the Supplemental Billing Instructions on the Health PAS Online Portal which explains how to bill Patient Driven Payment Model (PDPM) services.
For questions, please contact Bruce Cosgrove, Provider Relations Specialist.
On February 26, 2025, we announced that, absent emergency action by the Legislature, the Department would need to temporarily hold certain provider payments beginning with the payment cycle that will run on March 12, 2025. As of the time of this message, the Legislature has not approved the necessary funding to avoid these measures.
Effective January 1, 2025, we implemented new rates for Section 101, Medical Imaging Services.
The Office of Aging and Disability Services (OADS) is excited to announce a statewide marketing effort to increase awareness of Adult Day Services.
The marketing plan includes digital, broadcast and cable television, and streaming segments as well as a refresh to the OADS Adult Day Services webpage.
As of May 1, 2025, providers of Section 97 appendix E (PNMI E) must submit clinical documentation supporting medical necessity.
Providers must submit this clinical documentation into the Atrezzo system every 90 days as part of each member’s continued stay review. The documentation must include all of the following:
The member’s diagnosis
Level of care utilization system (LOCUS) score
Treatment plan