UPDATE for Providers Billing on UB-04 and 837I Claims, CR 107682
Effective August 31, 2022, UB-04 and 837I claims submitted without an attending provider will be denied.
MaineCare Benefits Manual, Chapter II, Section 25, Dental Services (repeal); Chapter III, Section 25, Allowances for Dental Services (repeal); Chapter II, Section 25, Dental Services and Reimbursement Methodology (rule replaces the two repealed rules)
The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website
Re-entry Update #8
June 30, 2022
Good afternoon,
Just a quick reminder that tomorrow is the last day for workers to fill out the DHHS Telework Approval Forms which can be found at the Office Re-entry Planning for DHHS site. We encourage you all to fill it out, even if you prefer not to telework. After tomorrow, this Form will be used for updated and adjusted schedules, new workers, and workers whose supervisors subsequently determine that they are eligible for telework.
Re-entry Update #7
June 27, 2022
Good morning,
This is the last week for workers to fill out the DHHS Telework Approval Form. The deadline is Friday, July 1.
All the information you need to know can be found at the Office Re-entry Planning for DHHS page (you can also navigate to it by visiting the DHHS homepage, hovering on “About Us” then clicking on “Staff” and scrolling down to the bottom of the page – it is the last bullet).
MaineCare in Education: Correction to TM and TL Modifier Language for Private Duty Nursing (PDN) Medical Necessity
Earlier today, we sent a message that included incorrect detail about using TM and TL modifiers. See the bolded bullet list below for corrected language.
Attention Home Health Service Providers: Tomorrow, July 1, 2022 EVV Soft Launch Implementation
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.
Attention Nursing Facilities and Residential Care Facilities – Rate Letters for State Fiscal Year 2023
Attention Nursing Facilities and Residential Care Facilities – Rate Letters for State Fiscal Year 2023
Rate letters for providers in Section 67 and Section 97, Appendix C will be delayed. Rate letters will be sent out no later than September 1, 2022. Rates listed on those letters will be retroactive to July 1, 2022.
MaineCare in Education: Private Duty Nursing (PDN) Medical Necessity
As a reminder for all providers of PDN services for members under the age of 21, the determination of medical necessity for PDN services in the home should not be contingent on whether the member receives PDN services at school.
How to Adjust Claims for Retro Rate Increase
There are two ways you can update your claims to get reimbursed for a retro rate increase.
Option One: Straight Reversal
You can do a straight reversal, which takes back the original payment and allows you to bill a new clean claim. You have one year from the date of service to submit a correct claim.
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.