MaineCare Bulletins

Date Title Topic
Looking Ahead: Eligibility-Dedicated Data Feed to Support MaineCare Renewals and Enrollment General, All Services
Fiscal Year 2027 (FY27) Rate Correction: Section 97, Appendix C, Residential Care Facilities Long Term Care Services
Section 90, Physician Services: Retroactive Rate Update Effective January 1, 2026, CR#142205, 142218 Hospital & Clinic Services, Primary Care and Care Coordination
Section 90: Quarter 3, Physician Drug and Seasonal Flu Code Update: CR 142091, 142074 Hospital & Clinic Services, Primary Care and Care Coordination
Attention Trading Partners: MIHMS Upgrade October Payment Cycle Changes and System Access Limitations Critical Communications
Attention Trading Partners: Training for New MaineCare Partner Portal General, All Services
Section 45: Hospital Non-Claims Payment Schedule for October 2026 Hospital & Clinic Services
MaineCare in Education: Updated Joint Individual Education Program (IEP) Guidance for School Health-Related Services School Health Related Services
MaineCare Comprehensive Benchmarking Report Initiation Notice General, All Services
Registration is Open for the 2026 MaineCare Provider Conference General, All Services
Section 80, Pharmacy Dispensing Fees: Final Draft Rate and Comment Summary Retail Pharmacies
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter III, Section 20, Allowances for Home and Community-Based Services for Adults with Other Related Conditions State & Federal Policy
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 20, Home and Community Based Services for Adults with Other Related Conditions State & Federal Policy
Attention Trading Partners: Training for New MaineCare Partner Portal General, All Services
Final Notification to Trading Partners about Taking Action Now Before MaineCare’s New Online Portal Goes Live General, All Services
Reminder-Upcoming Pause in Configuration Changes General, All Services
2027 MaineCare Eligibility Changes: Information, Resources, and Partner Briefing General, All Services
Attention Trading Partners: MIHMS Upgrade October Payment Cycle Changes and System Access Limitations Critical Communications
Upcoming Federal Changes to MaineCare Eligibility for Some Non-citizens General, All Services
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter I, Section 1, General Administrative Policies and Procedures State & Federal Policy
MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter I, Section 1, State & Federal Policy
Attention Trading Partners: Take Action Now Before MaineCare’s New Online Portal Goes Live General, All Services
Attention Trading Partners: Training for New MaineCare Partner Portal General, All Services
Reminder for Billing Attending Provider on UB-04 and 837I Claims, CR 110840 General, All Services
Save-the-Date: DHHS Partner Briefing on Federal Medicaid Work Requirements and Increased Renewals Critical Communications
Section 50, Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID): New Fiscal Year (FY) 27 and REVISED FY26 Rates & Letters, CR 141649, 141868 Long Term Care Services
Pharmacy Prior Authorization and Claims Denials: Enroll to Avoid Denials Critical Communications
Registration is Open for the 2026 MaineCare Provider Conference Long Term Services and Supports, Retail Pharmacies, School Health Related Services
Attention Trading Partners: Training for New MaineCare Partner Portal General, All Services
Single Assessment Timing Requirements Reminder Behavioral Health (BH)
Title 5 License Maintenance Case General, All Services
Intensive Outpatient Program (IOP) Clinical Eligibility Review and Billing Criteria for Section 45 and 46 Hospitals Update Hospital & Clinic Services
Stakeholder Group Meeting: Nursing Facility Reform Transition Fund General, All Services, Long Term Care Services
Upcoming Pause in Configuration Changes General, All Services
Registration is Open for the 2026 MaineCare Provider Conference Dental Services, Hospital & Clinic Services, Specialty Services
Section 18, Home and Community Based Services for Adults with Brain Injury Rate: Additional Services Identified for Removal of Service Provider Tax (SPT) CR 141031 Long Term Services and Supports
Addition of the TH Modifier to Support National Maternity Care Coding and Reimbursement Changes Effective September 1, 2026 General, All Services, Hospital & Clinic Services, Primary Care and Care Coordination
Section 65 Requirement for Monthly Average of Three Contacts per Week for Children’s Assertive Community Treatment (ACT) and Home and Community Based Treatment (HCT) Behavioral Health (BH)
New MaineCare Partner Portal Training for Trading Partners General, All Services
MaineCare Telehealth Services Provider Licensure Requirements General, All Services
Upcoming Pause in Configuration Changes General, All Services
Provider Responsibility Regarding Third Party Liability and Secondary Billing General, All Services
Attention Trading Partners: Take Action Now Before MaineCare’s New Online Portal Goes Live General, All Services
Provider Update: Federally Required MaineCare Off-Cycle Provider Revalidation Plan General, All Services
Provider Type Limitations for Section 28 School-Related Services School Health Related Services
Section 45, Hospitals: Inpatient Cost-of-Living Adjustments (COLA), & DRG Weight Update, CRs 141509, 141515, 141524 Hospital & Clinic Services
Free Clinical Consults for Patients Living with HIV Primary Care and Care Coordination
Registration is Open for the 2026 MaineCare Provider Conference Behavioral Health (BH), General, All Services, Primary Care and Care Coordination
Section 97, Appendix C, Residential Care Facilities (RCFs): New Rates Implemented, CR 141206 Long Term Care Services
Sections 14, 30, 31, 45, 90 & 103: Long-Acting Reversible Contraceptives (LARC) Rates Implemented Hospital & Clinic Services, Primary Care and Care Coordination