RESCHEDULED: Section 45, Hospital Service Providers: Public Forum Draft Reimbursement Methodologies
The Department has identified a new date and time for the Section 45 public review and comment forum.
Public Review and Comment
MaineCare Cost of Living Adjustments (COLAs) Effective July 1, 2024
MaineCare is increasing reimbursement rates for certain services in the policy sections listed below, through a COLA as directed by MRS Title 22, §3173-J (referred to as ‘Rate Reform Statute’). The COLA will be effective July 1, 2024, and is equal to an increase of 2.54% above the currently established rate(s). This COLA increase is proportional to the percentage increase in the Maine minimum wage as determined by the Maine Department of Labor.
Attention Section 45, Hospital Distinct Psychiatric and Distinct Substance Use Disorder (SUD) Units: July 2024 Cost of Living Adjustment (COLA) Updates
MaineCare is increasing the per-diem base rates for Section 45, distinct psychiatric and distinct SUD units, as directed by MRS Title 22, §3173-J (referred to as ‘Rate Reform Statute’). The increase will be effective July 1, 2024. This increase is calculated by using inflation provided by the economic trend factor from the most recent addition of the “Healthcare Cost Review” from IHS Markit.
Recoupment of Claim Payments for Non-Covered Services Processed Under the COVID-19 Uninsured Benefit After the End of the Federal Public Health Emergency (PHE)
As explained in the January 17, 2024, e-message, MaineCare’s COVID-19 Uninsured Benefit was available for uninsured individuals through the end of the federal PHE, which ended May 11, 2023. MaineCare will not pay for services for this population for dates of service after May 11, 2023.
Section 31, Federally Qualified Health Centers (FQHCs) Annual Cost of Living Adjustments (COLAs) Effective July 1, 2024
MaineCare is increasing reimbursement rates for Section 31, FQHCs through a COLA directed by MRS Title 22, §3173-J (referred to as ‘Rate Reform Statute’). The COLA will be effective July 1, 2024. New rates were calculated using the FQHC Market Basket percentage as published by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services as directed by MRS Title 22, §3174-V.
Section 23, Developmental and Behavioral Clinic Services: Child Abuse Evaluations, Comment Summary and Final Draft Rate
On May 13, 2024, the Office of MaineCare Services initiated a rate determination process* for Section 23, Child Abuse Evaluations. We held a virtual public forum on May 17, 2024, to present the draft rate model to interested parties and allowed for public comment. Interested parties were able to submit written comments through May 21, 2024.
Maine CDC Encourages Steps to Protect Your Health from Hepatitis C
AUGUSTA– As Hepatitis Awareness Month in May concludes this week, the Maine Center for Disease Control and Prevention (Maine CDC) is encouraging Maine people to take steps to protect their health from these viral illnesses.
Electronic Visit Verification (EVV) Online Training Available
There are no additional live trainings for EVV scheduled after April 25, 2024. Providers can request Ad Hoc EVV Training by emailing MihmsTraining@gainwelltechnologies.com to schedule a training.
Register for online trainings through Absorb:
Update**: MaineCare Cost of Living/“Part AAAA” Adjustments
MaineCare increased reimbursement rates for certain services through a cost-of-living adjustment (COLA) as directed by 22 MRSA Section 3173-J and 22 MRSA Section 7402, as enacted by Maine P.L. 2021, ch. 398, Part AAAA. The COLA is effective as of January 1, 2024, and is equal to an increase of 2.54% above the currently established rate(s).