On March 30, MaineCare provided notice regarding the financial status of the state and its need to temporarily withhold reimbursement. Relevant from the notice:
For the payment cycle that will run on April 2, we will continue to take only the following actions, consistent with the approach for the previous three payment cycles:
- Pay Critical Access Hospital prospective interim payments (PIPs) at 70 percent the normal levels;
- Hold payment for all hospital claims greater than $50,000;
- Hold payment for multi-state chain, large health system and out-of-state retail pharmacies and durable medical equipment services; and
- Hold payment for out-of-state providers of hospital, ambulance, pharmacy (excluding pharmacies within 15 miles of the Maine border) and durable medical equipment services.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.