• Read more about Section 25 Dental Services Rulemaking Update 

MaineCare is expanding Dental Services to include coverage for adults, investing in reimbursement rates, and updating the entire policy to make it consistent with up-to-date evidence-based procedures and practices. These changes will take effect on July 1, 2022, by emergency rulemaking. Emergency rules have a maximum effective period of 90 days. The Department will propose a routine technical rule within 7 to 14 days of the emergency rule to make these changes permanent. 

• Read more about Attention Section 97, Appendix D Children’s Residential Care Facility Providers - Supplemental Payment Information 

Per PL 2022, ch. 635, Sec.

• Read more about Re-entry Update 6

Good afternoon,

We continue to field questions, conduct training, and see submissions of the DHHS Telework Approval Forms. Many thanks to all of you who have participated to date. As a reminder, you have until next Friday, July 1 to fill out an Approval Form to seek approval to continue teleworking after September 6.

• Read more about Attention Providers of Section 21 Home Support Agency Per Diem: Enforcement Discretion Related to Reimbursement for Asleep Staff 

The Department recently adopted amendments to Section 21 rules (10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 21). The rules clarified longstanding policy related to overnight staff in group homes.

• Read more about Attention Home Health and Hospice Service Providers: July 1, 2022 EVV Soft Launch Implementation and MaineCare Member Letter

Home Health Soft Launch

This message is another reminder about the Electronic Visit Verification (EVV) “soft launch” period for providers of section 40 Home Health and section 43 Hospice services ahead of the January 1, 2023 federal implementation deadline that was originally announced August 13, 2021.

• Read more about Attention Providers of Section 18, 19, 20, 21, and 29 Services: Appendix K to Maine’s Home and Community Based Waivers Continues to Provide Temporary Flexibilities on Service Caps, Staffing

Appendix K to Maine’s Home and Community-Based Services 1915(c) waivers provides the state certain flexibilities in waiver program operations during an emergency. Maine’s Appendix K and amendments may be found here. 

• Read more about Attention Behavioral Health Service Providers - Behavioral Health and Targeted Case Management Supplemental Payment Information 

Per PL 2021, ch. 635, Sec.

• Read more about EPSDT Coverage for Children’s Residential Care Facility Level of Care

In certain exceptional and high-risk situations for youth under the age of 21, the Office of MaineCare Services (OMS) will approve a MaineCare member’s clinical eligibility for services in a Children’s Residential Care Facility (CRCF) under the Early Periodic Screening Diagnostic and Treatment (EPSDT) benefit, MaineCare Benefits Manual (MBM) Chapter II, Section 94, without requiring an attempt to use a lower level of care. 

• Read more about EPSDT Coverage for Children’s Residential Care Facility Level of Care​

In certain exceptional and high-risk situations for youth under the age of 21, the Office of MaineCare Services (OMS) will approve a MaineCare member’s clinical eligibility for services in a Children’s Residential Care Facility (CRCF) under the Early Periodic Screening Diagnostic and Treatment (EPSDT) benefit, MaineCare Benefits Manual (MBM) Chapter II, Section 94, without requiring an attempt to use a lower level of care. 

• Read more about Reminder for Providers Billing on UB-04 and 837I Claims, CR 107682

Effective June 30, 2022, UB-04 and 837I claims submitted without an attending provider will be denied.