Attention Providers: UPDATE on Issues Processing MaineCare Pharmacy Claims

Feb 27, 2024

In follow-up to our February 23, 2024, e-message,  

MaineCare has now instructed pharmacies that they can give MaineCare members a 30-day supply of prescriptions during this time, and process claims as they normally would.  The Department will pay all eligible claims submitted once the system is operational. It is working on the details for when and how such payments will be made and will release the details as soon as possible. Change Healthcare has not yet issued a timeline for resolution. The Department will communicate a timeline for resuming normal payments as soon as possible. 

Pharmacies must provide eligible MaineCare members covered prescriptions, and may not bill, demand, or otherwise seek reimbursement from that individual (or representative of the individual) for any MaineCare covered. 

We are also communicating this directly to members. MaineCare members with questions may call our Pharmacy Help Desk at 1-866-796-2463. They may experience delays due to call volume. 

We are working to determine a timeline for resolving these issues. We will send another message once we have more information or can announce a return to normal operations.