Sections 13, 17, 28, 65, and 92, Targeted Case Management and Behavioral Health Services – Rate Studies Comment Summary with Department Response

May 22, 2023

In the Spring of 2022, the Office of MaineCare Services (OMS) initiated rate determinations for MaineCare Benefits Manual (MBM) Sections 13, 17, 28, 65, and 92. Burns and Associates, a Division of Health Management Associates, conducted these rate studies. Providers submitted cost surveys in April and May of 2022. Burns used information obtained through the surveys, as well as stakeholder feedback, to inform the development of draft payment methods and rates. In September of 2022, after P.L. 2021 Ch. 639 became law, OMS issued formal public notice of the initiation of these rate determinations. MaineCare held several public forums in collaboration with our vendor in September, to present the draft rates and methodologies to interested stakeholders and provide opportunity for public comment. Stakeholders of sections 13, 17, 28, 65, and 92 submitted written comments through October 14, 2022 and Section 65 Crisis Service providers submitted comments through December 9, 2022. 

The final rates were posted and noticed on December 30, 2022, and took effect January 1, 2023. You may now view those updated fee schedules for each section on Health PAS Online Portal. The final rate models have been posted to the MaineCare Rate Reform page.  

In determining final rates for these services MaineCare reviewed and took into consideration all public input received. We thank all those who contributed. Because of the complexity of the comments and responses, MaineCare did not post written responses to public comments at the time the rates were finalized. We have now posted a summary of all comments, along with the Department’s responses.  

Please contact Bryan Lumbra MaineCare’s Rate Setting Project Manager for Targeted Case Management and Behavioral Health Services, with any questions on this rate study process.   

This notice is being sent pursuant to Public Law 2021, Chapter 639. In accordance with Ch. 639, the Department will engage in formal rulemaking to update the affected sections of the MaineCare Benefits Manual (MBM).