Section 31, Federally Qualified Health Centers (FQHCs): Cost-of-Living Adjustments (COLAs) Implementation Plan CR134712

 

As previously noticed, MaineCare is increasing all in-state FQHC rates to reflect a 1.0% COLA.

MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.

Section 97, Appendix C, Residential Care Facilities (RCFs) Cost-of-Living Adjustments (COLAs) Implementation Plan CR 134858

As previously noticed, MaineCare is adjusting the RCF direct care rates to reflect a 1.0% COLA.

MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.

Section 45 Hospitals: Cost-of-Living Adjustments (COLAs) Implementation Plan - CRs 134737 & 134738

As previously noticed, MaineCare is increasing certain hospital reimbursement rates to reflect a 1.0% COLA.

MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.

The following is being adjusted to reflect the COLA increase:

Section 91, Health Home Services - Community Care Teams (CCTs) & Section 93, Opioid Health Home Services: Cost-of-Living Adjustments (COLAs) Implementation Plan

As previously noticed, MaineCare is increasing reimbursement rates for Sections 91 and 93 to reflect a 1.0% COLA.

MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to June 21, 2025, to align with the regular billing cycle for these services.

Section 97, Private Non-Medical Institutions (PNMI) Appendix F: Rate Letters for Fiscal Year (FY) 2026, CR 134858

Section 97, Appendix F, FY 2026 rate letters will be accessible on the secure Health PAS Online Portal by September 24, 2025. To view them, log into your Trading Partner Account and follow this pathway: File Exchange > Reports > Rate Setting Letters.   

If you have questions about accessing the letters, please contact Provider Services at: 1-866-690-5585.     

For questions about the content of these letters, please contact the individual listed on the rate letters. 

Sections 23, 25, 30, 40, 89, 97 B & D, 102: Cost-of-Living Adjustments (COLAs) Implementation Plan

As previously noticed, MaineCare is increasing certain hospital reimbursement rates to reflect a 1.0% COLA.

MaineCare will implement new rates for billing when funding for this COLA is available to the Department on September 24, 2025. New rates will be effective retroactively to July 1, 2025.

MaineCare Notice of Agency Rule-making Proposal, Chapter III, Section 45, Principles of Reimbursement for Hospital Services

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the 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.

MaineCare Notice of Agency Rulemaking Proposal, Chapter III, Section 45, Principles of Reimbursement for Hospital Services

Notice of Agency Rulemaking Proposal

AGENCY: Department of Health and Human Services, Office of MaineCare Services, Division of Policy

CHAPTER NUMBER AND TITLE: 10-144 C.M.R, Chapter 101, Chapter III, Section 45, Principles of Reimbursement for Hospital Services

TYPE OF RULE: Routine Technical

PROPOSAL FILING NUMBER:

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