Attention MaineCare Members and Families, Healthcare Providers, Clinicians, Consumer Advocates, and Healthcare Professional Associations: CMS’ Make Your Voice Heard RFI 

The Centers for Medicare & Medicaid Services (CMS) released a Request For Information (RFI) seeking public input on accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency. Through this RFI, CMS also seeks to better understand the factors impacting provider wellness and learn more about the distribution of the healthcare workforce.

Maine Department of Health and Human Services Certified Community Behavioral Health Clinic Stakeholder Meeting 

The Department of Health and Human Services (DHHS) is initiating a bi-monthly virtual stakeholder meeting series to gather input and inform efforts on the development of a Certified Community Behavioral Health Clinic (CCBHC) model in Maine. The first meeting will Monday, September 26th, 10:30am-12pm, held virtually through Zoom. 

Attention Section 43 Hospice Providers Using the State Sandata Solution for Electronic Visit Verification (EVV) 

Hospice Functionality available in the State Sandata Solution 

Starting September 7, 2022, a new functionality has been made available for Hospice providers using the Sandata Solution. This new functionality will allow providers to create Prior Authorizations (PA) within the Sandata system. This will also allow providers to create an electronic visit record for MaineCare members who have a PA.   

Attention Section 97, Private Non-Medical Institutions Appendix D, Children’s Residential Care Facilities Providers 

Effective July 1, 2022, Children’s Residential Care Facilities (CRCFs) delivering Aftercare Services may now submit claims utilizing quarter-hour units. This change has been made to allow providers to bill more accurately for this service. The adjusted rate of reimbursement is as follows:    

Home and Community Based Settings (HCBS) Lifespan Project Listening Sessions 

Please join the Department of Health and Human Services’ Office of Aging and Disability Services (OADS), Office of Child and Family Services (OCFS), and Office of MaineCare Services (OMS) for a presentation and listening session on a proposed Lifespan Project for individuals with Intellectual and Developmental Disabilities (IDD).   

ATTENTION Correction to Section 92, Section 13, and Section 17 message to Providers: Passthrough process now required if organizations jointly serve an Opioid Health Home (OHH) Member   

This is a correction to the e-message sent on September 2, 2022, regarding Passthrough Payments for certain services. The message incorrectly stated that Opioid Health Homes (OHH) providers will need to enter authorizations codes for case management services provided by Section 92, Section 13, and Section 17 providers through Kepro.

Re-entry Update #11

Good morning,

We are now in the fourth phase of the Department’s re-entry process, which is about preparation. This includes preparing offices to have more workers in them.

To that end, we are moving ahead with the installation of sit-stand desks in offices. We expect many of them will be installed by September. We are working on the schedule to install the remainder in early fall. We hope you enjoy them.

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