Attention Pharmacy Providers: Status of Restoration of Maine Point of Purchase System (MEPOPS)

Jun 11, 2024

The Office of MaineCare Services is continuing a phased recovery following the service outage that occurred from February 21, 2024, through March 26, 2024, due to the national cyber security issue affecting Change Healthcare. The services below are now restored in MEPOPS:

• Drug Pricing Updates: National Average Drug Acquisition Cost (NADAC), Average Wholesale Price (AWP), Federal Upper Limit (FUL), and State Maximum Allowable Cost (SMAC), drug pricing reflects the most accurate and up-to-date pricing information.
• New Drug Products and National Drug Codes (NDCs) Updates: The MEPOP system is updated with the latest Medi-Span drug files. This update added the new drug products and NDCs released since February 21, 2024, that have been missing during the restoration process. Please resubmit any rejected claims awaiting this drug file update. 
• SMAC Disputes: The SMAC dispute process is restored. Pharmacies with SMAC disputes from the outage period or moving forward may submit the SMAC Dispute form and a copy of their invoice via email to SMACdisputes@optum.com. The SMAC dispute form is available at www.maine.gov/dhhs/oms/providers/pharmacy-services and by request through SMACdisputes@optum.com
• Rejected Claim Issues:

Providers requiring assistance with claims processing either with claims from the system outage period noted above or current claims, may contact the Optum Pharmacy Helpdesk at MaineHD@optum.com or 1-888-420-9711.

MaineCare Pharmacy Service Restoration Office Hours – Thursday June 13, 2024

For additional support, MaineCare is inviting you to join the next Office Hours call with the MaineCare Pharmacy team on Thursday, June 13, 2024, from 3:30 p.m. – 4:15 p.m. related to the current phase of service restoration. We will use this time as an opportunity for sharing questions and concerns and providing technical support from the State. Register in advance for this meeting:

https://mainestate.zoom.us/meeting/register/tZApf-mqqzwpGtBW3_5pAXYZ0xvyAwUyO1y9

If you have any questions or require further assistance, please do not hesitate to contact our Help Desk at 1-888-420-9711 or email MaineHD@optum.com Thank you for your continued support and efforts to serve MaineCare members.