MaineCare Notice of Agency State Plan Submission, 1915(k) Community First Choice State Plan Option
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the propose
Reminder: Primary Care Plus (PCPlus) Application is Open
MaineCare Services is pleased to announce that we are now accepting applications for participation in MaineCare’s PCPlus program. PCPlus is a MaineCare primary care model that gives Primary Care Providers (PCPs) greater flexibility and incentives to meet MaineCare members’ healthcare needs by transitioning away from a volume-based (fee-for-service) payment system toward population-based payments tied to cost and quality-related outcomes.
MaineCare Notice of Agency Rule-making Adoption, MaineCare Benefits Manual, Chapters II and III, Section 45
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the propose
MaineCare Rate System Reform
Our Goal
To provide a clear and transparent process for MaineCare rate determinations, with opportunities for robust participation from all interested stakeholders.
Get more information on how you can participate and to view our monthly Rate System Reform updates.
We continue to update this page with important dates and progress made on past, current, and future rate determination work. Please check in often, as this site is a work in progress.
Novavax Monovalent COVID-19 Vaccine Authorized for Use as Booster Doses in Adults Ages 18 and Older
On October 19, 2022, the Food and Drug Administration (FDA) reissued an Emergency Use Authorization letter (EUA) for the use of Monovalent COVID-19 vaccine booster doses from Novavax.
Atrezzo Upgrade
On Monday, November 7, 2022, Kepro will upgrade their web-based platform to Atrezzo Next Generation. The Atrezzo Next Generation (ANG) platform is an improved interface with enhanced security features such as Multi-Factor Authentication (MFA).
Training Plan and Resources
Proposed Rate Determination Schedule
Pursuant to Public Law 2021 Chapter 639, the Department must annually develop a schedule of rate determination in consultation with the MaineCare Rate Reform Expert Technical Advisory Panel (TAP). The Department must then post the proposed rate determination schedule on its publicly accessible website, provide an opportunity for the public to review and comment on the rate determination schedule, and make available a summary of these comments on its publicly accessible website.
Crown PA Exception for Endodontic Therapy, CR 112997
In response to comments submitted during the public comment period for the recently adopted Section 25, Dental Services and Reimbursement Methodology rulemaking, the Department indicated that it would pursue system changes to waive prior authorization (PA) requirements for crowns in qualifying circumstances.
Update to Providers Participating in the 340B Drug Program, CR 112772
A message sent on October 12, 2022, to providers participating in the 340B Drug Program did not identify a contact person for providers with questions.
Please reach out to Shannon Beggs of Provider Relations for any questions related to the 340B Drug Program.