Maine.gov
Provider Help Desk: (p) 888-420-9711 (f) 800-408-1088 | Member Help Desk: (p) 866-796-2463 (f) 207-287-8601
Prior Authorization (PA) Helpdesk (for Provider PA inquiries): (p) 888-445-0497 (f) 888-879-6938

General Pharmacy Info

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Name Description Date
Maintenance List as of 04.18.2019 1.34 MB 2019/07/11
MaineCare Abilify Splitting Table 56.93 KB 2019/02/19
Pharmacy Notice 2019 Plan Changes 44.86 KB 2018/10/05
Pharmacy List by Name 397.51 KB 2018/05/01
Pharmacy List by NPI 397.71 KB 2018/05/01
Morphine Sulfate Equivalent (MSE) Chart 211.81 KB 2018/02/05

CMS Rebatable List

Name Description Date
CMS Rebatable Drug List 1Q2019 6.28 MB 2019/07/18
CMS Rebatable Drug List 4Q2018 6.24 MB 2019/04/18
CMS Rebatable Drug List 3Q2018 6.21 MB 2019/01/15
CMS Rebatable Drug List 2Q2018 6.12 MB 2018/11/12
CMS Rebatable Drug List 1Q2018 810.8 KB 2018/06/15

Memos and Mailings

Name Description Date
Provider Newsletter July 2019 PDL Update 126.24 KB 2019/07/19
Provider Newsletter May 2019 PDL Update 39.2 KB 2019/05/23
Provider Newsletter April 2019 PDL Update 227.46 KB 2019/04/12
Brand Name Suboxone Film Update 125.01 KB 2019/03/11
Provider Newsletter January 2019 PDL Update 46.13 KB 2019/01/24
Pharmacy Benefit Update Winter 2018 237.12 KB PDL Changes will be effective January 1, 2019 2018/12/17
Provider Newsletter September 2018 PDL Update 47.69 KB 2018/09/27
Provider Newsletter June 2018 PDL Changes 42.39 KB 2018/06/11
Maine Outage Notice for June 29- July 2nd 85.86 KB 2018/06/11
ME_Provider_Pilot_Registration 233.48 KB Pharmacy Point of Sale (POS) Registration for Pharmacy Pilot Testing 2018/05/08
Maine Medicaid Pharmacy Pilot Testing Notification 380.06 KB 2018/05/08
Provider Newsletter May 2018 PDL Changes 70.97 KB 2018/05/01
Provider Newsletter February 2018 PDL Changes 41.32 KB 2018/02/15
Maintenance 90 day-Update and PDL Updates 141.45 KB 2018/01/22

Forms

Name Description Date
Reversal Form 21.81 KB 2014/08/28
MEPARTD Manual Claim Form NCPDP D.0 168 KB 2014/04/29
MEPOP Manual Claim Form NCPDP D.0 168 KB 2014/04/29
ME Compound Manual Claim form NCPDP D.0 168.08 KB 2014/04/29
BMS012 Form 64.22 KB 2010/12/23

Maine Rx Plus

Name Description Date
MaineRx Plus Pharmacy List by NABP 135.84 KB 2010/03/05
MaineRx Plus Pharmacy List by NPI 135.84 KB 2010/03/05
MaineRx Plus Pharmacy List by NAME 135.91 KB 2010/03/05