Balancing Incentive Program
In June 2012, CMS awarded Maine an estimated $21 million in enhanced Medicaid funds. (Source: CMS Balancing Incentive Program website)
BIP Application, link no longer available (5/1/2013)
Structural Change Work Plan, link no longer available.
Health Homes
In January 2013, CMS approved the state’s Health Homes State Plan Amendment. The MaineCare Health Home Initiative includes Stage A Health Homes for people with chronic conditions and Stage B Behavioral Health Homes for individuals with serious mental illness or serious emotional disturbance. (Source: CMS website; MaineCare Services website)
Approved Health Homes State Plan Amendment (1/22/2013)
Maine previously implemented Stage A of its Health Home Initiative. On October 11, 2013, DHHS posted a Behavioral Health Home RFA or Stage B of its Health Home Initiative. The state will implement Stage B of its Health Home Initiative in April 2014. Practices may participate in both Stage A and Stage B of the Health Home Initiative beginning April 2014. (Source: MaineCare Services Website)
As of May 2014, Maine has officially submitted to CMS a proposed Health Home SPA for the state’s second health home, but CMS has not yet approved the state’s second Health Home SPA. (Source: CMS Health Home website, 4/2014; Kaiser Health Home State Plan Option Website, 5/2014)
On December 17, 2014, CMS approved Maine’s second Health Home State Plan Amendment to implement Behavioral Health Homes for adults and children with significant mental health and co-occurring diagnoses, effective April 1, 2014. In April 2014, Maine began implementing Behavioral Health Homes as Stage B of its MaineCare Health Home Initiative. (Source: Medicaid SPA website, 1/2015)
Health Homes State Plan Amendment (Approved 12/17/2014)
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On July 10, 2017, the Maine Department of Health & Human Services (DHHS) codified what had been an emergency rule that lays out the framework for the establishment of Opioid Health Homes (OHH), which will serve the state’s Medicaid program, MaineCare. Opioid Health Homes will be responsible for providing the following services:
The new initiative aims to provide comprehensive and coordinated care to MaineCare members with a substance abuse dependency. DHHS notes that they have submitted a State Plan Amendment (SPA) to CMS for approval. Maine currently has two other Health Home programs, one targeted at individuals with chronic conditions, and another targeted towards those with significant behavioral health needs. (Source: Maine.gov 7/12/2017) On February 15, 2018, the Portland Press Herald reported on challenges the Maine Department of Health and Human Services (DHHS) has experienced with getting the state’s Opioid Health Homes program up and running. Thus far, the state has only spent $60,000 out of a planned $4.8 million in combined federal and state funds, and served five uninsured individuals and 50 Medicaid beneficiaries. Stakeholders argue that challenges surrounding reimbursements rates and numerous regulations are causing barriers to provider participation in the program. (Source: Portland Press Herald 2/15/2018) |