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
Pharmacy List by NPI 340.24 KB 2014/09/02
Pharmacy List by Name 340.24 KB 2014/09/02
Morphine Sulfate Equivalent (MSE) Chart 149.05 KB 2013/02/04
MaineCare PDL Splitting Tables 69.12 KB 2011/07/22
MaineCare PDL Dose Consolidation List 69.48 KB 2011/07/22

CMS Rebatable List

Name Description Date
CMS Rebatable Drug List 2Q2014 1.52 MB 2014/08/18
CMS Rebatable Drug List 4Q2013 11.04 MB 2014/02/18
CMS Rebatable Drug List 1Q2013 673.85 KB 2014/01/23
CMS Rebatable Drug List 3Q2013 716.18 KB 2013/11/18
CMS Rebatable Drug List 2Q2013 725.69 KB 2013/08/23

Memos and Mailings

Name Description Date
Provider Newsletter August PDL Changes 45.4 KB 2014/09/02
Provider Newsletter May PDL Changes 73.97 KB 2014/05/29
Pharmacy Benefit Update Spring 2014 152.57 KB 2014/05/29
Provider Newsletter April PDL Changes 78.16 KB 2014/04/10
Provider Notice D0 COB 3 Update 300.28 KB 2014/03/31
MaineCare 15 Day Initial Script Limit Update 73.37 KB 2014/03/21
Maine MEDICAID COB 3 Go LIVE Notice 199.34 KB 2014/03/21
Provider Registration Notice 43 KB 2014/02/17
Maine Medicaid Pilot Testing Notification 158.86 KB 2014/02/10
Provider Notice D0 COB 3 Changes 203.43 KB Informational Letter 2014/02/04
PDL Changes Effective January 1, 2014 91.32 KB 2013/12/13
Provider Notice Part D 2014 28.68 KB 2013/12/13
Pharmacy Benefit Update Summer/Fall 2013 127.79 KB 2013/11/12
Provider Newsletter September 09, 2013 77.78 KB 2013/09/09
Provider Notice Part D Copayments 279.12 KB 2013/08/08
EFT Payment Newsletter 67.75 KB 2013/07/25
Provider Newsletter June 19, 2013 72.21 KB 2013/07/25
Provider Newsletter April 10, 2013 137.45 KB 2013/07/25
Provider POS Claim Adjudication Reminders Memo 45.28 KB 2013/07/24
Provider Newsletter March 1, 2013 80.25 KB 2013/03/08
Opiate Limits Newsletter Update 92.51 KB 2013/01/24
Tamiflu Newsletter Update 86.24 KB 2013/01/24
Suboxone Limits Update 122.39 KB 2013/01/03
2013 Preferred Diabetic Supply List 275.81 KB 2013/01/03

Forms

Name Description Date
Reversal Form 24.76 KB 2014/08/28
MEPARTD Manual Claim Form NCPDP D.0 86.11 KB 2014/04/29
MEPOP Manual Claim Form NCPDP D.0 84.91 KB 2014/04/29
ME Compound Manual Claim form NCPDP D.0 80.83 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