• Read more about MC Rule #309A - 10-144 C.M.R. Ch. 333; Low Cost Drugs for the Elderly and Disabled (DEL) Eligibility Manual;

MaineCare Rule #309A - DEL Updates

The adopted rule updated Section 2, APPLICATION PROCESS, consistent with a legislative change to 22 M.R.S. § 3174-LLL made by P.L. 2023, ch. 412. Effective retroactive to July 1, 2024, individuals who are enrolled in Medicaid and/or Medicare Buy-In (MSP), who are eligible for Medicare Part D, and meet the income criteria in Section 2.2, are deemed to be eligible for and enrolled in DEL. These individuals do not need to file a separate application.

In addition, the adopted rule effectuates the following changes:

• Read more about 10-144 C.M.R. Ch. 331; Public Assistance Manual Temporary Assistance For Needy Families (TANF) Program; TANF Rule #120A - Step Disregard

The adopted rule effectuates changes to Chapter IV of the Public Assistance Manual Temporary Assistance for Needy Families (TANF) consistent with a legislative change to 22 M.R.S. § 3762 made by P.L. 2023, Ch. 29, An Act to Improve Family Economic Security Under the Temporary Assistance for Needy Families Program.

The adopted rule updated Chapter IV, B, INCOME DISREGARDS as follows:

• Read more about Attention Providers Interested in the Certified Community Behavioral Health Clinic (CCBHC) Medicaid Demonstration

Earlier this fall, MaineCare with its vendor Mercer, conducted a review of provisionally certified provider cost reports for the CCBHC Medicaid Demonstration. We used provider responses, in addition to other information, to create draft rate models for the services as part of the rate determination process*. We outlined this process during our kick-off meeting with providers on September 25, 2023.

• Read more about Attention HCBS Providers of Rehabilitative Services for Sections 19, 20, 21, 40, & 102: Interested Parties Engagement Session Presented Materials 

As previously noticed, MaineCare and its vendor are hosting several engagement sessions with interested parties to obtain important feedback as part of the rate determination process that was initiated in June of 2024, for certain HCBS services.   

• Read more about Section 90, Physician Drug Rate Updates, CRs 127124 & 127125

Quarter 3 Updates

The Department has retroactively updated the Physician Drug Rates effective July 1, 2024, in alignment with the Centers for Medicare & Medicaid Services’ (CMS) quarterly rate update. These new rates were implemented for billing on September 25, 2024. 

Oct 10, 2024

The Maine Department of Health and Human Services (DHHS) joined Governor Janet Mills and U.S. Surgeon General, Dr. Vivek Murthy, on September 27 for a panel discussion about building resilience through human connection.

• Read more about Department Co-Hosts Conversation with U.S. Surgeon General and Governor on Loneliness, Resiliency, and Reaching Out for Help

• Read more about Section 67, Nursing Facility Reform: Revised Draft Rates and Methodologies Public Forum

In January of 2023, as part of its reimbursement reform and rate determination priorities, the Department initiated a Rate Determination Process* for Section 67, Nursing Facility Services.

• Read more about Attention HCBS Providers of Personal Support Services for Section 12, 19, & 96: Interested Parties Engagement Session Presented Materials

As previously noticed, MaineCare and its vendor are hosting several engagement sessions with interested parties to obtain important feedback as part of the rate determination process that was initiated in June of 2024, for certain HCBS services.   

• Read more about 10-146 CMR Ch. 4 Disclosure of Vital Statistics Data, Reports and Records Rule

The Department adopted the amended rule, 10-146 CMR Chapter 4, Disclosure of Vital Statistics Data, Reports and Records Rule.

• Read more about Provider Communications and Training