Provider Bulletins by Topic

Date Title Topic
Attention Providers: Potential Capping of MaineCare Payment Cycles Behavioral Health (BH), Dental Services, Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services, Long Term Care Services, Long Term Services and Supports, Not in use, Not in use, Not in use, Primary Care and Care Coordination, Retail Pharmacies, School Health Related Services, Specialty Services, State & Federal Policy
340B Modifier Billing Reminder Extension – CR 129740 Hospital & Clinic Services
Residential Private Non-Medical Institution (PNMI) Appendix C Updated Rates for 2025 Long Term Care Services
Attention Providers: Potential Capping of MaineCare Payment Cycles General, All Services
Attention Providers: AIDS Drug Assistance Program (ADAP) 101 Webinar Available General, All Services
Survey for Providers of Personal Care and Home Health Services: Home and Community Based Services (HCBS) & Access Rule Long Term Services and Supports
MaineCare Notice of Agency Waiver Renewal, MaineCare Benefits Manual, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder Not in use, State & Federal Policy
Section 67, Nursing Facility (NF) Providers MAY NOW SUBMIT JANUARY CLAIMS Long Term Care Services
Providers of Section 17 Services – Telehealth Clarification Behavioral Health (BH)
Attention Section 67, Nursing Facility (NF) Providers: Implementation of NF Reform Billing Changes Long Term Services and Supports
Training Opportunity Available for Family and Caregivers of Adults Receiving Services Within Section 12, 19, and 96 Programs Long Term Services and Supports
MaineCare Notice of Agency Emergency Rule-making Adoption, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities Not in use, State & Federal Policy
Section 5, Ambulance Services January 1, 2025, Rate Update - CR 129313 Specialty Services
Attention MaineCare Providers: MaineCare Operations are Continuing as Normal at this Time General, All Services
Public Forum Cancelation: Home and Community Based Service (HCBS) Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, Assistive Technology & Personal Support Services Long Term Services and Supports
Certified Community Behavioral Health Clinics (CCBHC) Demonstration Comment Summary with Department Response Behavioral Health (BH)
Section 65 Behavioral Health Clarification of Authorization Requests for MAT/Suboxone & Medication Management Behavioral Health (BH)
Rate Determination Initiation Notice and Public Forum for Section 97, Private Non-Medical Institutions (PNMI) Appendix D, Temporary High Intensity Services Behavioral Health (BH)
Home and Community Based Service (HCBS) Providers of Clinical, Therapy, Care Coordination, Supportive Skills Building, Assistive Technology & Personal Support Services: Draft Rate Public Review and Comment Long Term Services and Supports
Calendar Year (CY) 2025 Rate Determination Schedule General, All Services
Correction to Section 67, Nursing Facility Rate Letters Published on January 16, 2025 Long Term Care Services
Attention Providers of Section 21 Agency Home Support: Information About Staffing Thresholds Long Term Services and Supports
Correction to ​Hospital Outlier Payment Methodology, CR 128941 Hospital, Family Planning, and Ambulatory Care/Clinic Services, Hospital & Clinic Services
Update to Electronic Visit Verification (EVV) Missing Clients in Sandata General, All Services
Revision of Medicare Standardization Rates General, All Services
Nursing Facilities (NFs) and Residential Care Facilities (RCFs), PNMI, Appendix C Rate Letters Long Term Care Services
Final Draft Rates for Certain Medicare Covered Family Planning Services and Long-Acting Reversible Contraception (LARCs): Sections 14, 30, 31, 45, 90 & 103 Hospital & Clinic Services, Primary Care and Care Coordination
Missing Clients in Sandata General, All Services
Section 50, Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) Rate Letters for Calendar Year (CY) 2025 Long Term Care Services
Section 97, Private Non-Medical Institutions (PNMI) Appendices E & F: Rate Letter Update Behavioral Health (BH), Long Term Care Services
Section 40, Home Health Services: Reimbursing Parents Providing Home Health Aide (HHA) Services Long Term Services and Supports
Reminder for all Providers: A 30-Day Notice is Required Prior to Closure General, All Services
Psychiatric Residential Treatment Facilities (PRTFs) Revised Draft Rates: Presented Materials & Comment Deadline Behavioral Health (BH)
Nursing Facilities (NF): January Claims Hold and Navigating Rate Reform Billing Changes Long Term Care Services
​​Section 28: Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Claim Denials, CR 129350​ Behavioral Health (BH)
Dental Services Forum Registration and Topics Dental Services
Opioid Health Homes (OHH) Pay-for Performance (P4P) Benchmark Announcement Behavioral Health (BH)
Correction to Hospital Psychiatric/Substance Use Disorder (SUD) Fee Tables, CR 128816 Hospital & Clinic Services
Microdyn Update for Diagnostic Related Groups (DRG), and Ambulatory Payment Classifications (APC), CRs 127722, 127723, 128406, 128150, & 128151 Hospital & Clinic Services
Board Certified Behavior Analyst (BCBA) and Telehealth Guidance for Section 28 Providers Behavioral Health (BH)
Section 45, Acute & Rehabilitation Hospital Providers: Reminder of Upcoming January 1, 2025, Outlier Methodology Changes Hospital & Clinic Services
Section 45, Critical Access Hospital (CAH) Providers: Reminder of Upcoming January 1, 2025, Changes Hospital & Clinic Services
Section 89, MaineMOM Performance-Based Adjustment Withhold Behavioral Health (BH)
Medicare Standardization Rate Updates for Calendar Year 2025 (CY25) General, All Services
Section 103: Rural Health Center (RHC) Calendar Year 2025 (CY25) Rate Update, CR 128922 Primary Care and Care Coordination
Attention Schools Delivering Section 28 Services Behavioral Health (BH), School Health Related Services
340B Modifier Billing Guidance Update General, All Services
Home and Community-Based Services (HCBS) Access Rule Town Hall Announcement Long Term Services and Supports
Taxonomy Code Requested on Claim Submissions – Portal Claims General, All Services
Rescheduled: Section 107, Psychiatric Residential Treatment Facilities (PRTFs) Revised Draft Rates Public Review and Comment Forum Behavioral Health (BH)