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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 websi
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 is January 1, 2023.
With these EVV deadlines quickly approaching, we continue to offer weekly provider and aggregator trainings and forums. All trainings and forums are online via Microsoft Teams.
On December 16, 2022, the Office of MaineCare Services (OMS) sent an announcement that we will cover the Pfizer BioN-Tech and Mode
Effective January 1, 2023, in accordance with the Centers for Medicare & Medicaid Services (CMS) application fee requirements, MaineCare’s provider enrollment application fee will increase to $688 per enrollment application. This increase will apply to new, reactivating, or revalidating providers, or when adding new service locations to an existing enrollment. You can pay the application fee by credit or debit card at the time of application submission.
In the Spring of 2022, prior to P.L. 2021 Ch. 639 becoming effective, the Department began work to establish National Diabetes Prevention Program (NDPP) services as a new benefit for which a section under the MaineCare Benefits Manual has yet to be determined. This message outlines the next steps in the process to establish this new service model.
PUBLIC REVIEW AND COMMENT
Effective January 1, 2023, the Department is updating reimbursement rates for Medicare covered codes and services. The new reimbursement rates will apply to the services noted below, with the updated rates reflecting 72.4% of the 2023 Medicare rates.
Effective January 1, 2023, the Calendar Year (CY) 2023 ICF-IID rate letters will be accessible on the Health PAS Online Portal. You can view them by logging into your Trading Partner Account and following this pathway: File Exchange > Reports > Rate Setting Letters.
Effective January 1, 2023, the Calendar Year (CY) 2023 RHC rate letters will be accessible on the Health PAS Online Portal. You can view them by logging into your Trading Partner Account and following 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. If you have questions about the content of the letters, please contact Rate Setting directly using the contact name and phone number on the letters.
Effective January 1, 2023, the Calendar Year (CY) 2023 FQHC rate letters will be accessible on the Health PAS Online Portal. You can view them by logging into your Trading Partner Account and following this pathway: File Exchange > Reports > Rate Setting Letters.
Some Ambulatory Payment Classifications (APC) claims are overpaying when COVID-19 administration codes are billed in addition to an office visit (i.e., HCPC G0643). The COVID-19 administration code is paying 100% of APC accurately, and the office visit code is paying 100% of APC in error. MaineCare is responsible for paying 100% of APC only on the COVID-19 administration codes. We will notify you once the system is updated. No provider action is needed. Claims that overpaid incorrectly will be adjusted.