• Read more about ​MaineCare Residential Substance Use Disorder (SUD) Treatment Providers – Utilization Management (UM) Process Update

One of the tasks associated with MaineCare’s 1115 SUD waiver is the “establishment of a Utilization Management (UM) approach for appropriate access and level of care for SUD services, including an independent process for reviewing placement in SUD residential treatment”. This UM is a component of Maine’s Implementation Plan and Special Terms & Conditions approved by the Centers for Medicare & Medicaid Services (CMS) for this waiver and was implemented in July 2023. 

• Read more about Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Section 45, Hospital Services

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Section 45, Hospital Services

NATURE OF PROPOSED CHANGES: The Department plans to address the following changes in hospital reimbursement:

• Read more about Notice of MaineCare Reimbursement Methodology Change, The MaineCare Accountable Communities Program

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  The MaineCare Accountable Communities Program

• Read more about Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Sections 67, Nursing Facility Services and Section 97, Private Non-Medical Institution (PNMI) providers delivering services through Appendix C

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Sections 67, Nursing Facility Services and Section 97, Private Non-Medical Institution (PNMI) providers delivering services through Appendix C, Principles of Reimbursement for Medical and Remedial Service Facilities

• Read more about Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Section 97, Private Non-Medical Institution (PNMI) Substance Use Treatment Facilities (Appendix B) and Children's Residential Care Facilities (Appendix D)

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Section 97, Private Non-Medical Institution (PNMI) Substance Use Treatment Facilities (Appendix B) and Children's Residential Care Facilities (Appendix D)

• Read more about Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Section 13, Targeted Case Management Services

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Section 13, Targeted Case Management Services

• Read more about Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Section 67, Nursing Facility Services

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Section 67, Nursing Facility Services

• Read more about Maine CDC Reports Death from Powassan Virus

Death is the first fatal case in 2024, one of three infections identified this year from the tickborne virus

AUGUSTA – The Maine Center for Disease Control and Prevention (Maine CDC) today confirmed the first fatal case of Powassan virus infection in Maine this year. The death occurred in York County. The last prior death from the tickborne virus in Maine occurred in May 2023.

• Read more about Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Family Planning Services

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Family Planning Services

NATURE OF PROPOSED CHANGES: The Department plans to amend reimbursement of certain family planning services, effective July 1, 2024. These changes are as follows:

• Read more about Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Section 25, Dental Services and Reimbursement

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Section 25, Dental Services and Reimbursement