DHHS → node
The State of Maine has identified a technical issue within the Health PAS Online Portal. Gainwell will need to shut down the system for maintenance for periods of time. In an effort to minimize provider impact, Gainwell will shut down the portal for the following periods of time when data shows the lowest user activity:
On July 15, 2025, the Office of MaineCare Services (OMS) with our vendor presented revisions to the previously proposed community-based Mobile Crisis Intervention Response service rates and model.
Emergency Services, also known as Emergency MaineCare, is a limited benefit that covers emergency medical services to stabilize the emergency condition only. For proper reimbursement, providers must use Admission Type “1” on the UB04 claim form or the Emergency Indicator “Y” on the CMS 1500 claim form.
Beginning September 1, 2025, MaineCare will only pay for prescriptions that are from providers who are enrolled with MaineCare.
On July 2, 2025, we sent a notice stating that the implementation of the 1.95% COLA for several sections of policy was delayed.
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) Rate Letters
On June 5, 2025, MaineCare announced we planned to increase reimbursement rates through a Cost-of-Living Adjustment (COLA) for certain services, effective July 1, 2025. For select providers, this increased the part AAAA add-on and is in addition to the 1% direct care adjustment that is pending a 90 day wait. See the July 3, 2025, announcement for those details.
10-144 C.M.R. Ch. 330; Higher Opportunity for Pathways to Employment (HOPE) Rules
Section 4
HOPE Rule 104A - Dental Services Update
10-144 C.M.R. Ch. 301; Supplemental Nutrition Assistance Program (SNAP) Rules
Section 111-7
SNAP Rule #238A - ABAWD Update
The adopted rule effectuates routine technical changes to 10-144 C.M.R. Chapter 301; Supplemental Nutrition Assistance Program (SNAP) Program Rules, Section 111-7, ensuring consistency with 7 C.F.R. § 273.24(c).
Please join us on Wednesday, July 16, 2025, to learn about, and provide feedback about the next phase of MaineCare’s PCPlus reform work. This session will be an opportunity for practices to provide feedback on your experiences and insights from participating in the PCPlus model. Your input will help shape the next phase of the PCPlus Alternative Payment Model (APM).
Discussion Topics: