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The Department now has available the Behavioral Health Rate FAQ document on billing and authorizations for services for Sections 28 and 65. The Department will send another e-message to notify you about additional guidance after we work through the details of those questions.
The Maine Department of Health and Human Services (DHHS) is in the process of implementing rate studies for Sections 2, 13, 17, 26, 28, 65, and 92. Once implemented, these rate increases will be effective as of January 1, 2023. The Department has posted State Plan methodology notices detailing the rate changes for Sections 13, 17, 26, 28, 65, and 92 on our State Plan Methodology page. If a code for a service is not listed on these notices, there is no rate change for that code
To view the full announcement, click here.
On Monday, November 7th, Kepro will be upgrading their web-based platform to Atrezzo Next Generation. The Atrezzo Next Generation (ANG) platform is an improved interface with enhanced security features such as Multi-Factor Authentication (MFA). ANG brings the Maine Administrative Services Organization (ASO) an even more flexible, intuitive, and highly automated system that streamlines the utilization review and reporting processes for clients and providers. ANG fulfills all components of the scope of services defined in the Maine ASO UM program, as it offers the modularity and flexibility needed to evolve with the ever-changing healthcare technology landscape. Our flexibility comes from ANG’s best-in-class platform, custom-built by Kepro, which can be rapidly configured and tailored to meet ASO’s unique program needs.
Training Plan and Resources
A full functioning array of resources including training manuals, informational materials, webinars, and training videos are utilized. Training materials will be placed on the Maine ASO client website, located at http://www.qualitycareforme.com/. Training session will be a recorded demonstration in a live webinar to allow discussion and answer questions. There will be several modules for the providers to attend based on user role permissions. Providers will receive links to register for the session date and time that works best for their availability.
For a list of our upcoming trainings, please visit https://me.kepro.com/providers/atrezzo/
Please click here to view the Office of MaineCare Listserv announcement.
Attention Referents of MaineCare Benefits Manual Section 97, Appendix D Children’s Residential Care Facility Services. Currently, Referents are expected to review the CRCF Information Sheet with families prior to a referral to CRCF services. As part of the application for CRCF services, the Acknowledgement Form must also be signed by the family and youth with the appropriate service checked off.
Effective immediately, Referents must also review the Aftercare Support Services Information Sheet with families and youth as part of the referral for CRCF services. Both CRCF and CRCF Aftercare Support Services must be checked on the Acknowledgement Form.
Attention Providers of MaineCare Benefits Manual Section 97, Appendix D Children’s Residential Care Facility Services, the Aftercare Support Services Information Sheet should be reviewed with youth and families upon admission to the CRCF. Additional information about Aftercare Support Services can be located in the Aftercare Support Services FAQs.
For Referents and Providers of MaineCare Benefits Manual Section 97, Appendix D Children’s Residential Care Facility Services, the Aftercare Support Services Webinar is now available. OCFS recommends all referents review the webinar prior to making referrals for CRCF services.
The Office of Behavioral Health (OBH), in coordination with Kepro, have updated the definitions of a Critical Incident to better clarify when it must to be reported through the Kepro Atrezzo system.
A Level One (1) Critical Incident are those that result in death or serious injury and/or significantly jeopardize clients, public safety, or program integrity. Such incidents involving clients must be reported to OBH regardless of the location of the incident. A client’s death is always reported as a Level 1, regardless of whether the death was attended or not, and regardless of the cause of death.
Examples of Level 1 Critical Incidents include:
A Level Two (2) Critical Incident are those where significant errors or undesirable events that compromise quality of care or client safety occur.
Examples of Level 2 Critical Incidents include:
To access the Critical Incident training please visit https://me.kepro.com/resources/training/
For questions regarding this change or the upcoming training please contact Kepro Provider Relations at 1-866-521-0027, Option 3, or via email at ProviderRelationsME@kepro.com
Effective May 1, 2022, you must submit a PA to Kepro for all youth determined eligible for CRCF services. The PA will be valid for six months. This includes new CRCF referrals and Transfer CRCF referrals.
If the child does not access CRCF services within the six-month timeframe, you must complete a new referral with all required documentation, including the Behavioral Health Program Coordinator (BHPC) Consult. The new referral will initiate a new assessment with a Kepro clinical reviewer. You can submit the new referral up to 10 days prior to the end of the current authorization and may backdate it up to a maximum of five business days.
Youth Authorized Prior to May 1, 2022
For all youth authorized for CRCF services but not placed prior to May 1, 2022, please submit an extension request in Atrezzo prior to the end of the current authorization period. If approved, we will authorize the extension for six months. If the child does not access CRCF services within the six-month timeframe, you must complete a new referral with all required documentation including the BHPC Consult. The new referral will initiate a new assessment with a Kepro clinical reviewer. You can submit the new referral up to 10 days prior to the end of the current authorization and may backdate it up to a maximum of five business days.
The CRCF services application, directions, and Provider Guide, are available at Maine ASO | Children’s Residential Care Facility (CRCF) Services.
Please contact the Kepro intake team with any referral process questions at 1-866-521-0027 or IntakeME@kepro.com.