Attention: MaineCare Provider Enrollment Updates

Sep 15, 2023

The Office of MaineCare Service (OMS) is providing the following information about the status of provider enrollment case processing timeframes. MaineCare is experiencing a high volume of enrollment cases. In addition, our provider enrollment credentialling vendor, Gainwell Technologies, is experiencing staffing shortages. These challenges are causing provider enrollment cases to take much longer to process than normal, resulting in many pending enrollment cases. Currently, some enrollment cases are taking over 60 days to complete. 

OMS and Gainwell are working diligently to reduce both the number of pending cases and overall case processing time. OMS and Gainwell are investigating the root causes, Gainwell has added staff members, and we together continue to evaluate staffing levels. Additionally, we are assessing whether technological upgrades could help automate certain enrollment processes in the mid to longer term. To support timely processing, providers are reminded they should update their enrollment information, such as new licenses, as soon as possible after receiving that update, and well before their license expires. 

If a provider is experiencing hardship as a result of these delays and their enrollment case has remained pending for more than 60 days after submission, they should contact their assigned Provider Relations Specialist. Waiting until your case has remained pending for at least 60 days will assist us in managing this ongoing backlog of cases. A list of the Provider Relations Specialists by service type and their contact information is located on the OMS website here: Provider Relations Specialists    

We understand that these challenges impact your day-to-day operations. We are working hard to implement solutions and to keep enrollment cases processing as quickly as possible. We will follow up regularly to provide status updates. Please watch for our next update within the next couple of weeks.