Update on Medication Assisted Treatment (MAT) Claims - Claims Adjusted due to Temporary MaineCare Coverage

Update on Medication Assisted Treatment (MAT) Claims 

MaineCare recognizes there were system issues that impacted the reprocessing of claims with code H0020, Medication-Assisted Treatment, that resulted in several of these claims denying for exceeding limits. Those issues have been corrected, and the claims are now processing appropriately. Claims that were denied will be reprocessed by MaineCare, and no provider action is needed.  

As a reminder, per Section 65, Chapter III, of the MaineCare Benefits Manual, H0020 is a weekly code and should be billed with one unit. We recommend using a date range of Sunday through Saturday.  

Please contact Provider Relations Specialist, Rebecca Maranda, with questions. 

Claims Adjusted due to Temporary MaineCare Coverage, CR 87873 

When an individual does not receive an eligibility decision within 45 days of applying for MaineCare, they receive coverage on the 46^th day, until an eligibility determination is made. If the individual is found eligible for MaineCare at a later date, the claims processed during the period of temporary coverage are adjusted to reflect the correct eligibility category for the member for State financial reporting purposes. You will see the adjustments to these claims on your Remittance Advice as the amount for the service taken back and then reimbursed again. No provider action is required.