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PCPlus providers will receive their first quality performance reports in April 2023. These reports aggregate performance at the practice level for available measures. Providers will receive these initial reports via email through the contact listed in their PCPlus application. If you need to update your practice contact information, please email PCP-Network-Services.DHHS@maine.gov.
The Office of MaineCare Services increased the reimbursement rate for the Section 50, Day Habilitation Services (T2021 w/ Rev Code 0907) rate to $8.71 (per 15-minute unit) retroactively to January 1, 2023, in accordance with Chapter III, Section 50 of the MaineCare Benefits Manual which states that the Department shall reimburse Community Support services affiliated with ICF-IDD services in accordance with reimbursement for Community Supports under Section 21, Chapters II & III, Home and Community Benefits for Memb
On January 30, 2023, the Biden-Harris Administration announced that the federal COVID-19 PHE will end on May 11, 2023. The Department is diligently reviewing all PHE-related flexibilities and is developing guidance to clearly articulate what flexibilities will end, along with associated timeframes. We plan to update our website resources and send out additional e-messages over the coming weeks and months.
This proposed rule updates the average nursing care private rate, listed in Chart 4.3 of the MaineCare Eligibility Manual, to the most current figure available from the Department's internal audit team. Effective June 1, 2023, the average nursing care private rate is determined from rates reported by nursing facilities on the MaineCare Cost Report. The rule also adds a description of how the rate is used to calculate penalty periods for disposing of assets for less than fair market value on or after the look-back period.
On March 30, 2023, MaineCare held an online public meeting to present a draft Alternative Payment Methodology (APM) along with the rationale for the recommended methodology for section 31, Federally Qualified Health Centers.
Appendix K to Maine’s HCBS 1915(c) waivers provides the state certain flexibilities in waiver program operations during an emergency. Maine’s Appendix K and amendments may be found on Medicaid.gov.
DHHS is hosting a webinar to orient prospective or new Section 97, Appendix B Residential Substance Use Disorder (SUD) providers to DHHS. The webinar will include the following topics:
As a follow up to the notice on February 2, 2023, the Department has updated the Behavioral Health Rate FAQ document on billing and authorizations for
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.
We continue to offer weekly provider and aggregator trainings and forums. All trainings and forums are online via Microsoft Teams.
On May 29, 2022, MaineCare adopted changes to the rounding rule in Chapter I, Section 1.03-8(J), effective January 1, 2023, which the Department will not enforce until May 1, 2023. MaineCare provided a future effective date and delayed enforcement of the rule to give providers time to make necessary system changes to bill for partial units of service.