MaineCare to Save Money with Better Management of Care
As budget pressures mount on the state to save money in the MaineCare program, the Department of
Health and Human Services (DHHS) is working to make those savings through better management. Two
big changes will happen this fall.
First, DHHS has hired a new company to "prior approve" certain outpatient mental health services
for MaineCare children and adults. This means that your health care provider must ask the company
to approve certain health care services before you can receive them. This company will also make sure
that once a service begins, it really is helping you.
DHHS believes that it can save money by more carefully assessing MaineCare members' need for ongoing
care. This may make it more difficult for some people to get some services. But it may also help
people get care that really works.
There is a second big change in how some people will get services through MaineCare. DHHS has
hired another company to work with MaineCare members who have complex and costly health needs. It's
called "care management." Staff of the company will help people with chronic health conditions
get their prescriptions filled and get the lab work that they need. They will also help make sure
that barriers to care, such as transportation, don’t keep people from getting the care they need.
DHHS will contact those people who are eligible for this new program. No one will be forced to
participate. We are hopeful that this will be a win/win for the MaineCare program and for MaineCare
members - saving money and helping people become healthier.
MAIN and Maine Equal Justice Partners will be watching to make sure that these two new changes
help, and don’t hurt people. If you have problems with either of these new programs, please
contact Crystal Bond at Maine Equal Justice
(1-866-626-7059).
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