• Read more about Residential Private Non-Medical Institution (PNMI) Appendix C Updated Rates for 2025

Some of the 2025 rates for residential care facilities, PNMI Appendix C, were not updated. This caused claims to pay at the 2024 rates. We will update the rates in MIHMS and reprocess claims billed at the 2025 rates. No provider action is needed.

For questions, please contact Bruce Cosgrove, Provider Relations Specialist.

• Read more about 340B Modifier Billing Reminder Extension – CR 129740

Effective January 1, 2025, the modifier JG is no longer valid for 340B claims. We are extending the date to March 1, 2025, to allow providers additional time to update their systems. Please see our previous message for more information.

The Office of MaineCare Services will adjust denied claims between January 1, 2025, and February 28, 2025, and no provider action is required.

Contact Shannon Beggs, Provider Relations Specialist, with questions. 

• Read more about 10-144 CMR Ch. 258; Control of Notifiable Diseases and Conditions Rule-Proposed

The Department proposes routine technical rule changes to its rule to control specific notifiable communicable, occupational, and environmental diseases and conditions, as authorized by Maine law (22 MRS chapter 250). Proposed changes include adding COVID-19, Enterococcus resistant diseases, Hard Tick Relapsing Fever, Hepatitis C (acute and chronic), Mpox virus infection, PFAS serum test results and removing Rabies post-exposure prophylaxis from the notifiable diseases list, which will align with US CDC’s priorities for state surveillance.

• Read more about Survey for Providers of Personal Care and Home Health Services: Home and Community Based Services (HCBS) & Access Rule

As part of the Maine Department of Health and Human Services’ (DHHS) preparations for the Access Rule’s HCBS requirements, please complete this survey by February 14, 2025.

Please see the Office of Aging and Disability Services (OADS) webpage for more information about Access Rule and HCBS information.

• Read more about Attention Providers: AIDS Drug Assistance Program (ADAP) 101 Webinar Available

On March 5, 2025, The Maine Centers for Disease Control (CDC) staff is offering a free 30-minute webinar at 11:30 AM. The webinar covers what health care office staff need to know about the ADAP program, including: 

• Read more about MaineCare Notice of Agency Waiver Renewal, MaineCare Benefits Manual, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder

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 website is updated to reflect the changes.  The MaineCare Benefits Manual is available on-line at the Secretary of State’s website. 

• Read more about Section 67, Nursing Facility (NF) Providers MAY NOW SUBMIT JANUARY CLAIMS

MaineCare implemented the NF reform changes on February 1, 2025.  

Claims for dates of service starting on or after January 1, 2025, may now be submitted for reimbursement.  

Please see our earlier notice for billing guidance and additional billing resources.  

• Read more about SNAP Rule #227P - Noncitizen Language

10-144 C.M.R. Chapter 301 - Supplemental Nutrition Assistance Program (SNAP) Rules;

Alpha Index, Table of Contents, Sections 1, 111-2, 222-5, 222-6, 444-1, 444-4, 444-8, 555-3, and 999-1

SNAP Rule #227 - Noncitizen Language

• Read more about MaineCare Rule #310A - Section 2, Part 9 Update

10-144 C.M.R. Ch. 332; MaineCare Eligibility Manual

Part 2

MaineCare Rule 310A – Section 2, Part 9 Update

Effective Date: February 4, 2025

• Read more about MaineCare Notice of Agency Waiver Renewal, MaineCare Benefits Manual, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder

Notice of Agency Waiver Renewal

AGENCY:  Department of Health and Human Services, MaineCare Services

RULE TITLE OR SUBJECT: Chapter 101, MaineCare Benefits Manual, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder.

WAIVER: ME.0159, Intellectual Disabilities or Autism Spectrum Disorder Waiver