Section 30, Family Planning, Updated Base Rates and Resulting Final Rates - CR 130980

Effective January 1, 2025, MaineCare updated the base rates and resulting final rates for certain Family Planning Services delivered by eligible providers. These new rates were implemented for billing on April 2, 2025.

Only providers engaged primarily in the delivery of sexual and reproductive health care services, as described in 42 United States Code, Section 1396d(a)(4)(c), are eligible to bill add-on rates.

Attention MaineCare Providers: Status of Temporary MaineCare Payment Holds – April 3, 2025

On March 5, 2025, the Department shared the plans to temporarily hold certain MaineCare provider payments beginning with the payment cycle that ran on March 12, 2025. 

At this time, the current payment withholding approach will continue unless further emergency action is taken by the legislature to make funds available sooner. The situation remains fluid, and we are closely monitoring projections to inform decisions.

Attention Primary Care Plus (PCPlus) Practices: PCPlus Application and Recertification Opening – Required for all PCPlus Practices

We are pleased to announce that the PCPlus application period is now open! The application is open until Friday, May 2, 2025. 

PCPlus is a MaineCare primary care model that gives Primary Care Providers (PCPs) greater flexibility and incentives to meet MaineCare members’ healthcare needs by transitioning away from a volume-based (fee-for-service) payment system toward population-based payments tied to cost and quality-related outcomes. Participation in PCPlus is voluntary for PCPs, and PCPs must apply to participate.    

Two Types of PCPlus Aplications   

Certification Standards For Persons Conducting Chemical Analyses For The Detection And Identification Of Seized Drugs; 10-144 CMR c. 266

The Department adopted this routine technical rule change to amend Chapter 266. This rulemaking coincides with the expiration of the emergency rule effective January 2, 2025, ensuring competency requirements and accreditation standards adopted on an emergency basis remain the standard for labs analyzing controlled substances seized by law enforcement and used in Maine's courts procedures. This non-emergency rule incorporates the changes adopted by emergency rule to update the oversight authority and certification standards, including the educational and training requirements.

Reminder: Blood Lead Testing Requirements and MaineCare Reimbursement

This message provides clarity about MaineCare requirements, coverage, reimbursement, and incentives of blood lead testing for children.

Maine law requires testing of all children aged one and two-years (22 M.R.S. §1317-D). Blood lead testing is also a performance measure within the following MaineCare models, which means there is a financial incentive to provide these critical tests:

Attention Providers: HCV and HIV Clinical Guidance Package Webinar

This webinar is an overview of the Maine CDC HCV and HIV Clinical Guidance Package, developed in collaboration with on-the-ground local partners to address the intersectionality of HIV, viral hepatitis, sexually transmitted infections (STIs), and harm reduction services. This clinical guidance package contains resources for health care providers to use for screening, treatment, prevention, and patient care.           

Objectives for the session: 

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