MaineCare Rate Reform Expert Technical Advisory Panel (TAP) Consultation on Draft CY2025 Rate Determination Schedule

Pursuant to Rate Reform law (MRS Title 22, 3173-J), MaineCare will host our Annual Draft Rate Determination Schedule Consultation with the TAP on March 14, 2025, from 1:00 PM to 2:30 PM via Zoom. This meeting is open to the public. There will be a limited period of time at the end of the meeting for public comment. 

Zoom Meeting

https://mainestate.zoom.us/j/84867322771

Attention Nursing Facility (NF) Administrators and Directors of Nursing: NF Quality Partnership Call Related to Quality Payment in the New NF Rate Model

The Department will host an important educational call via Zoom for NF Administrators, Directors of Nursing, and other key members of your Quality Assurance Performance Improvement (QAPI) team on February 19, 2025, from 1:00 - 2:30 PM. The meeting will address quality components of the new NF payment model.  

You may register through Zoom.     

MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities

Notice of Agency Rule-making Proposal

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

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities

PROPOSED RULE NUMBER:

CONCISE SUMMARY:

Disclosures of Organizational Change Reminder

If your organization is going through an organizational change, please contact Gainwell to receive guidance before beginning an enrollment/revalidation/re-enrollment application or maintenance case and prior to submitting the Disclosure of Organizational Change for MaineCare form. This allows Gainwell/MaineCare to review the change and decide what is the best way the provider needs to enroll or update their enrollment.

Please contact the MaineCare Enrollment email box with questions.  

Payment Error Rate Measurement (PERM) Reporting Year (RY) 2024 Errors

All errors found during a PERM audit are considered improper payments.Maine is required to reimburse the federal government for all improper payments and has the right to seek recoupment from providers for improper payments resulting from provider error.

The most common errors found in the RY 2024 PERM Audit cycle are listed below. The most common errors from the previous two PERM cycles are also included in the list. Before submitting a claim, check that the information for the member and the services provided are accurate and complete.

10-144 CMR Ch. 266; Certification Standards For Persons Conducting Chemical Analyses For The Detection And Identification Of Drugs

The Department is proposing this routine technical rule change to amend Chapter 266, to coincide with the expiration of the emergency rule effective January 2, 2025, ensuring competency requirements and accreditation standards remain the standard for labs analyzing controlled substances seized by law enforcement and used in Maine’s courts’ procedures. The proposed non-emergency rule changes incorporate those emergency changes adopted by emergency rule to update the oversight authority and certification standards, including the educational and training requirements.

Maine DHHS and Maine Child Welfare Action Network Release Five-Year Roadmap for Child Safety and Family Well-Being

Plan Builds on Progress Uniting Communities, Organizations, and Leaders to Strengthen Support for Families

AUGUSTA-- The Maine Department of Health and Human Services (DHHS) and the Maine Child Welfare Action Network (MCWAN) today announced the release of Maine's Child Safety and Family Well-Being Plan (2025-2030), a comprehensive five-year plan aimed at promoting the safety and well-being of children in Maine by strengthening support for families.

Attention Providers: Potential Capping of MaineCare Payment Cycles

In January, Governor Mills submitted to the Legislature a Fiscal Year 2025 supplemental budget request for $118 million in General Funds to align projected expenditures with available funding in the MaineCare program. The funding is available through new revenues recently recognized by the State of Maine’s nonpartisan Revenue Forecasting Committee. The Governor’s request must simply be approved by the Legislature in order for the funding to be appropriated to MaineCare.

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