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On October 4, 2023, MaineCare held its Annual Draft Rate Determination Schedule Consultation with the TAP which was open to the public. See the recording of the presentation to the TAP, along with the presented
MaineCare is experiencing a high volume of enrollment cases and Gainwell Technologies is experiencing staffing shortages. These challenges cause provider enrollment and revalidation cases to take longer to process than normal, some taking over 60 days to complete. We understand that these challenges may impact your day-to-day operations.
This bulletin provides notice that the Department has initiated a rate determination process* for a new service model under review for future proposal as MBM, Section TBD: Palliative Care Interdisciplinary Team Services. The Office of MaineCare Services will conduct this rate determination with data and cost analytics support from the National Academy for State Health Policy’s (NASHP’s) Institute to Improve Care for People with Serious Illness.
Oct 10, 2023
Today, the Maine Department of Health and Human Services (DHHS) announced that Ian Yaffe will become the new Director of the Office for Family Independence (OFI) and current OFI Director Tony Pelotte will become a Senior Advisor for Eligibility System Reform in the Commissioner’s Office effective October 30, 2023. These changes will expand capacity and increase the Department’s ability to respond to Maine’s changing demographics, economy, and policies.
*As of July 26, 2024, FPSOs are no longer required to register in Maine.
Please see letter for explanation here.
A Temporary Nurse Agency (TNA) is a business entity or subdivision thereof of a business entity that primarily provides nurses, certified nursing assistants and other qualified staff to another organization on a temporary basis within the State of Maine. A TNA does not include an agency licensed in the State of Maine as a home health care services provider. To search for a registered TNA in Maine, click here.
AUGUSTA – The Maine Center for Disease Control and Prevention (Maine CDC), Maine Forest Service (MFS), and 211 Maine remind Maine residents and visitors to protect themselves from browntail moth hairs this fall.
The EVV requirements for Home Health providers delivering services under Section 40 were implemented on January 1, 2023.
We continue to offer weekly 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
MaineCare covers births and newborn care at out-of-state hospitals in most circumstances. Please see clarification below in response to questions from out-of-state providers about the process for submitting birthing claims to MaineCare.
Effective October 1, 2023, Federal MDS assessments no longer support Resource Utilization Group (RUG) III/IV grouper calculations. MaineCare reimburses NFs using a modified RUG III grouper calculation. NFs perform MDS assessments on NF residents which determines both resident level of care and NF reimbursement. This federal change will impact how NFs submit information to the Centers for Medicare & Medicaid Services (CMS) and MaineCare.