MaineCare Bulletins

Date Title Topic
Attention Section 18, 21, and 29 Providers: Evergreen Electronic Data Interchange (EDI) 837 Prior Authorization (PA) Issue Resolved, CR 123785 Long Term Services and Supports
Pemgarda (pemivibart) Receives Emergency Use Authorization (EUA) General, All Services
Attention Primary Care Plus (PCPlus) Practices - Open Application Period Required for all PCPlus Practices General, All Services
CORRECTION to Comment Deadline: Section 25, Dental Benchmarking Results and Draft Rates, Presented Materials and Comment Dental Services
Comment Deadline Extended: Section 67, Nursing Facilities (NF) Draft Rate Methodology Long Term Care Services
Section 25, Dental Benchmarking Results and Draft Rates, Presented Materials and Comment Deadline Dental Services
Electronic Visit Verification (EVV) Training Long Term Services and Supports
Attention Residential Care (PNMI-C) Facilities: CoreQ Resident and Family Satisfaction Survey Pilot Long Term Care Services
CORRECTION to Comment Deadline: Section 25, Dental Benchmarking Results and Draft Rates, Presented Materials and Comment Dental Services
Training Opportunity Available for Section 19 Home and Community Based Services for Older and Disabled Adult Caregivers Long Term Services and Supports
Section 30, Family Planning, REVISED 2024 Base Rates and Resulting Final Rates, CR 123812 Hospital & Clinic Services
Section 14, Advanced Practicing Registered Nursing (APRN) and Section 90, Physician Services: REVISED 2024 Anesthesiology Rates, CR 123809 Hospital & Clinic Services, Primary Care and Care Coordination
REVISED Section 90, Primary Care Provider (PCP) Rates Effective March 9, 2024, CR 123810 Primary Care and Care Coordination
Attention Pharmacy Providers: Status of Initial Restoration of Maine Point of Purchase System (MEPOPS) Retail Pharmacies
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
EVV Providers – Update to Latest Version of the Sandata Mobile Connect (SMC) App Long Term Services and Supports
Comment Deadline Extended: Section 67, Nursing Facilities Draft Rate Methodologies​ Long Term Care Services
Attention Residential Care (PNMI-C) Facilities: CoreQ Resident and Family Satisfaction Survey Pilot Long Term Care Services
REVISED Medicare Standardization Rates Effective March 9, 2024: Sections 15, 68, 75, 85, and 109 Specialty Services
Attention Providers of Section 28, Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations Behavioral Health (BH)
REVISED - Medicare Standardization Rates for Calendar Year 2024 (CY24) General, All Services
Evergreen Users Billing 837 Claims Long Term Services and Supports
Attention Pharmacy Providers: Updated Technical Instructions for Processing Backlogged Claims from February 21, 2024, through March 26, 2024 Retail Pharmacies
RESCHEDULED: Service Disruption Office Hours with MaineCare Pharmacy Benefit Retail Pharmacies
Palliative Care Interdisciplinary Team Services (Section TBD) – Rate Study Kickoff Presented Materials General, All Services, Hospital & Clinic Services, Primary Care and Care Coordination
RESCHEDULED: Service Disruption Office Hours with MaineCare Pharmacy Benefit Retail Pharmacies
Public Forum Rescheduled: Section 45, Hospital Service Providers Draft Reimbursement Methodologies Hospital & Clinic Services
Attention Primary Care Plus (PCPlus) Practices - PCPlus Application and Recertification Opening – Required for all PCPlus Practices Primary Care and Care Coordination
Attention Primary Care Plus (PCPlus) Practices: Reminder - PCPlus Open Office Hour  Primary Care and Care Coordination
Attention Pharmacy Providers: Service Disruption Office Hours with MaineCare Pharmacy Benefit Retail Pharmacies
Attention Providers: Update on Phased Restoration of Change Healthcare Systems General, All Services
Attention Pharmacy Providers: Confirmed Initial Restoration of Maine Point of Purchase System (MEPOPS) on March 27, 2024 Retail Pharmacies
Taxonomy Code Requested on Claim Submissions – Portal Claims General, All Services
Attention Providers: Submit Documentation Electronically to Avoid Delays General, All Services
​Public Review Rescheduled: Section 25, Dental Service Providers Benchmarking Results and Draft Rates​​ Dental Services
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Attention Pharmacy Providers: Resharing a Scheduling Link - Maine Point of Purchase System (MEPOPS) will return to service on March 27, 2024 Retail Pharmacies
Comment Deadline Extended: Section 67, Nursing Facilities Draft Rate Methodology Long Term Care Services
Attention Pharmacy Providers: Maine Point of Purchase System (MEPOPS) will return to service on March 27, 2024 Retail Pharmacies
CORRECTED LINK: Attention Pharmacy Providers: Service Disruption Office Hours with MaineCare Pharmacy Benefit Retail Pharmacies
Section 45, Hospital Service Providers: Public Forum Draft Reimbursement Methodologies Hospital & Clinic Services
MaineCare Notice of Agency Waiver Renewal-MaineCare Benefits Manual, Section 18, Home and Community Based Services for Members with Brain Injury Not in use, State & Federal Policy
Attention Pharmacy Providers: Service Disruption Office Hours with MaineCare Pharmacy Benefit Retail Pharmacies
Attention Licensed Marriage and Family Therapists (LMFTs) and Mental Health Counselors (MHCs) Behavioral Health (BH), Primary Care and Care Coordination
Attention Providers: Instructions to Change Billing Clearinghouse General, All Services
Attention Pharmacy Providers: Announcing Expanded Interim Payments for Certain Pharmacies and Continued Response to Change Healthcare Service Disruption Retail Pharmacies
Electronic Visit Verification (EVV) Phase 2 Trainings Long Term Services and Supports
Revalidate with MaineCare to Avoid Claim Denials General, All Services
Training Opportunity Available for Section 19 Home and Community Based Services for Older and Disabled Adult Caregivers Long Term Services and Supports
Section 90, Physician Services: REVISED 2023 Rates Primary Care and Care Coordination