Section 25, Dental Services: Benchmark Assessment Results Comment Summary with Department Response

Jul 19, 2024

In October of 2023, the Office of MaineCare Services provided notice that we had initiated the process of assessing previously established benchmarks for Section 25, pursuant to MRS Title 22, 31373-J, (2.)(D.)(2.). This statute requires that services benchmarked to a non-Medicare source be updated to the most current year of data for the payer source at least once every two years. The Department hosted a virtual public forum in April of 2024, to present the benchmark assessment results along with the rationale for the recommended rates and allowed for public comments. Written comments were accepted through the deadline of May 3, 2024.  

As a result of this assessment, the Department has determined that the existing methodology no longer represents the most appropriate benchmark and payment model, as required by Rate Reform Statute and a full rate determination will be required. We are assessing the current rate determination schedule to determine if we will be able to conduct the full determination ahead of the original 5-year timetable. In order to avoid an immediate threat to public health, safety, or general welfare, the Department has filed an emergency ruling to maintain the current MaineCare reimbursement rates and to extend the temporary exceptions in Section 25.06(B)(3).  

A summary of all comments is available on the MaineCare Rate System Reform webpage. The comment summary includes the Department’s responses, with an explanation of whether and how feedback was incorporated into the final draft rates.   

MaineCare reviewed and took into consideration all public input received, and we thank all those who contributed. 

For questions on this process, please contact Jessica Levesque, MaineCare’s Rate Reform Project Manager.  

This notice is sent pursuant to Title 22 MRSA §3173-J.