Update**: MaineCare Cost of Living/“Part AAAA” Adjustments

MaineCare increased reimbursement rates for certain services through a cost-of-living adjustment (COLA) as directed by 22 MRSA Section 3173-J and 22 MRSA Section 7402, as enacted by Maine P.L. 2021, ch. 398, Part AAAA. The COLA is effective as of January 1, 2024, and is equal to an increase of 2.54% above the currently established rate(s). Part AAAA requires this increase with the objective to ensure that the labor components of rates for these services continue to equal at least 125% of Maine minimum wage.

The Department will post the updated fee schedules for the Sections below that were *pending approval of appropriations to the Rate Setting page of the MaineCare Health PAS online portal as they are completed. Providers should continue to bill the 2023 rates that are currently in effect. Please do not hold claims. In response to requests for alternative means of reimbursement for this increase; Reimbursement for this increase can only be made through claims because the Department does not have federal authority to pay through other means, i.e. non-claims payments. Once new rates are implemented, providers will be responsible for adjusting claims as deemed appropriate by the provider and billing guidance will be provided at that time.

**Update: New rates for Sections that were pending appropriations will be implemented in August of 2024, retroactive to January 1, 2024.

These COLAs affect rates for eligible services under the following Sections of the MaineCare Benefits Manual (MBM):

COLA Rate Adjustments: MaineCare Benefits Manual Sections and Services

Section 2*

Adult Family Care Services

Section 12

Consumer Directed Attendant

Section 13*

Targeted Case Management Services

Section 17*

Community Support Services

Section 18

HCBS for Adults with Brain Injury

Section 19

HCBS for the Elderly and Adults with Disabilities

Section 20

HCBS for Adults with Other Related Conditions

Section 21

HCBS for Members with Intellectual Disabilities or Autism Spectrum Disorder

Section 26*

Day Health Services

Section 28*

Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations

Section 29

Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder

Section 65*

Behavioral Health Services

Section 92*

Behavioral Health Home Services

Section 96

Private Duty Nursing and Personal Care Services

 

Note: these COLA adjustments only apply to rates specified under these Sections of Policy for eligible services: when a Section of Policy cross-references rates in a separate Section of Policy, the reimbursement provisions in the cross-referenced section of policy dictates the reimbursement amount (e.g. services that are driven by reimbursement under Section 90, will not receive this COLA).

Please contact your Provider Relations Specialist for questions related to this billing guidance.

Check out our new MaineCare logo! Learn more about this logo on the About Us page of our website.

MaineCare logo