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In follow up to our January 19, 2024 notice, service codes and rates for Sections 68 and 85 of the MaineCare Benefits Manual, effective January 1, 2024, are now implemented to reflect 72.4% of the most recent 2024 Medicare rates.
Adjustment of Claims
You may be aware that Change Healthcare is experiencing a network interruption related to a cyber security issue. As a result, MaineCare is experiencing intermittent network issues processing claims. If you experience issues with claims, please follow your routine offline claims processing procedures. We are working to gather more details about the impacts and determine a timeline for resolving these issues and will return to normal business as soon as possible.
On September 8, 2023, in partnership with the Maine Center for Disease Control and prevention, MaineCare authorized a standing order for licensed pharmacists to create a single use prescription for OTC naloxone two dose nasal spray kit. This standing order can be accessed on the MaineCare website in the Provider Resources section under the Pharmacy header.
As previously shared in our October 31, 2023 provider bulletin, certain Appendix K flexibilities for sections 18, 21, and 29 have continued beyond November 11, 2023. The Centers for Medicare & Medicaid Services (CMS) plans to approve the corresponding 1915(c) waiver amendments necessary to make these changes permanent effective March 1, 2024.
Effective February 10, 2024, the Centers for Medicare & Medicaid Services’ (CMS) quarterly updates are complete in MIHMS. The following CMS documents provide the details of the APC updates:
https://www.cms.gov/files/document/r12419cp.pdf
This 30-minute live webinar will cover updates from Maine State Housing Authority and the MaineCare Housing Outreach and Member Engagement (HOME) programs. A recording will be posted on MaineCare’s website. Register for the webinar. We look forward to seeing you there!
Please contact Emily Bean with questions.
The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.
We continue to offer weekly EVV provider and aggregator trainings. All trainings are online via Microsoft Teams.
NOTE: The Absorb training system has been updated to allow providers to register for trainings more than once.
EVV Training Schedule
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EVV Phase 2 Training and Aggregator Content – State and Provider Trainings |
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Effective January 1, 2024, the Department has 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 February 15, 2024.
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.
On July 19, 2023, the Department implemented the revised rates for Enhanced Primary Care Provider services, effective January 1, 2023.
Adjustment of Claims
The Office of Aging and Disability Services is excited to announce a virtual training opportunity scheduled for Monday, March 18, 2024- Mental Health First Aid. This training is being provided under collaboration with the National Alliance on Mental Illness (NAMI) Maine and is available for caregivers providing care to Section 19 members. Caregivers can include personal support staff, attendants, home health aides, CNAs, nurses or other natural and family supports.