Provider Relief Fund Update and Tuesday, 7/28 Q&A Session for MaineCare’s PNMI Appendix C, E, and F Providers - New Questions in Kepro’s Atrezzo Portal: Referral Providers for Children’s Behavioral Health Services, Sections 28 and 65

Provider Relief Fund Update and Tuesday, 7/28 Q&A Session for MaineCare’s PNMI Appendix C, E, and F Providers

As a reminder, MaineCare providers now have until August 3, 2020 to apply to the CARES Act Medicaid Provider Relief Fund (PRF), which is intended to support Medicaid providers who have experienced revenue losses and/or increased costs during the COVID-19 pandemic.  

We have learned that some MaineCare providers may have concerns about potential future state recoupment of PRF funds. This message is to clarify that DHHS Audit will only look into a provider’s receipt and use of federal COVID-19 relief funds as part of its standard review process for cost-settled services. The only services that are both subject to cost settlement and are delivered by providers that may be eligible for the PRF are Private Non-Medical Institution (PNMI) Appendices C, E and F services.  

In addition, there appears to be confusion regarding the role and scope of MaineCare Program Integrity versus DHHS Audit.  MaineCare Program Integrity would not investigate a provider’s receipt and use of federal COVID-19 relief funds unless in response to reports of alleged provider fraud regarding these funds. In summary, aside from cases of reported fraud, the only services for which DHHS, including MaineCare, may look into the receipt and use of PRF funds are PNMI Appendices C, E and F.  

DHHS Audit and MaineCare are hosting a webinar tomorrow afternoon for PNMI Appendices C, E, F providers to provide clarification regarding the treatment of PRF funds and expectations for documentation of the use of PRF funds as part of the cost settlement process. We will also be available to answer questions. 

Any PNMI Appendix C, E, and F provider who would like to join this informational session should contact Kim Keezer (207-287-2093) at MaineCare to RSVP. 

In the meantime, we encourage all providers to review the PRF audit reporting requirements and terms and conditions set forth by the U.S. Department of Health and Human Services. Additional information regarding the PRF can be found on MaineCare’s COVID-19 website.

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New Questions in Kepro’s Atrezzo Portal: Referral Providers for Children’s Behavioral Health Services, Sections 28 and 65

This message is regarding MaineCare Benefits Manual, Section 28, Rehabilitative and Community Support (RCS) Services and Section 65 Home and Community Treatment (HCT) for Children with Cognitive Impairments and Functional Limitations.

Effective immediately, KEPRO, in coordination with the Office of Child and Family Services has added questions to the referral for RCS and HCT services in the Atrezzo portal.

The questions required are as follows:

1. Is the member’s need for service primarily due to their Intellectual Disability/Developmental Disability diagnosis?

2. Have you explored Multi Systemic Therapy (MST) or Functional Family Therapy (FFT) services? Multi Systemic Therapy and Functional Family Therapy

• If the answer is yes: “Which service was explored?”  and “When did you refer the member to this service? 
• If the answer is no: “Why was the member not referred to these services?”  

Please contact Kepro with questions regarding the referral or matching process for RCS and HCT services at IntakeME@kepro.com.