September 24, 2021 MaineCare Updates
Maine Department of Health & Human Services sent this bulletin at 09/24/2021 02:39 PM EDT
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Pharmacy Point of Sale (POS) Blackout Period on October 6, 2021
The POS system will be unavailable for approximately eight hours starting at 8:00 PM on Wednesday, October 6, 2021 for system maintenance. Pharmacy claims will not be adjudicated during this time.
MaineCare would like to thank all pharmacy providers for their patience during this process and we apologize for any inconvenience this may cause. Please call the POS Helpdesk with questions at 1-888-420-9711.
Update Regarding Upcoming Changes to Chapter II, Section 60, Medical Supplies and Durable Medical Equipment (DME)
This is an update to our September 14th e-message regarding changes to the reimbursement methodology for all DME and medical supplies, unless otherwise specified, to 88.2% of the current year Medicare rural and non-rural fee schedule amounts.
In response to an informal request from the Centers for Medicare & Medicaid Services’ (CMS) for more information on our planned methodology, we are delaying the effective date, originally planned for October 1, 2021. We will follow up with more information and a new effective date as soon as we are able.
Until a new effective date is determined, Section 60 rates will remain at the amounts included on the posted fee schedules.
As a reminder, changes are necessary to comply with the Centers for Medicare and Medicaid Services’ (CMS) Upper Payment Limit (UPL) requirement. MaineCare’s proposal is also pursuant to P.L. 2021, Ch. 398, Sec. A-17, An Act Making Unified Appropriations and Allocations for the Expenditures of State Government, General Fund and Other Funds and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2021, June 30, 2022 and June 30, 2023.
Please contact Policy Writer, Henry Eckerson with questions about this change.