Bill > LD1758

This bill establishes an expedited enrollment process for healthcare providers in the MaineCare program (Maine's Medicaid program). Under the new law, the Department of Health and Human Services must provisionally approve enrollment applications within 48 hours for providers who have a national provider identifier (a unique 10-digit identification number issued by federal Medicare and Medicaid authorities) and work for healthcare entities with a 90% or higher enrollment approval rate in the previous five years. During a 60-day provisional approval period, the department can conduct a full review of the application, but the provider is automatically considered fully approved if no denial is issued within that timeframe. However, the department retains the right to suspend or revoke approval if a material deficiency is discovered. If a provider's approval is revoked, they must go through the standard enrollment process and cannot use the expedited path for future enrollment. The Office of MaineCare Services can also seek reimbursement for any payments made during the provisional approval period if the provider's approval is ultimately revoked. The bill requires the department to create rules defining key terms like "good standing" and "material deficiency" and establishing procedures for implementing this expedited enrollment process.

Health and Social Services

https://legislature.maine.gov/legis/bills/display_ps.asp?LD=1758&snum=132