HOME HEALTH CARE SERVICES PROVIDER IN MAINE

Fatumata Kaba
Aug 12
3 min read

SUPPORTING INDIVIDUALS’ INDEPENDENCE AND WELL-BEING THROUGH IN-HOME MEDICAL AND SUPPORTIVE CARE

Home Health Care Services in Maine help individuals—especially seniors and persons with disabilities—maintain independence by delivering medical and non-medical care in the comfort of their homes. These services are funded through MaineCare (Maine’s Medicaid program), including Home and Community-Based Services (HCBS) Waivers, private insurance, and Medicare for eligible individuals.

1. GOVERNING AGENCIES

Agency: Maine Department of Health and Human Services (DHHS)

Role: Oversees licensing and regulation of home health agencies and HCBS Waiver programs

Agency: Office of MaineCare Services

Role: Administers Medicaid-funded home health and personal support services under Section 40 and Section 19 waivers

Agency: Division of Licensing and Certification (DLC)

Role: Issues licenses for Home Health Agencies and conducts compliance inspections

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures that Maine’s programs meet federal HCBS standards

2. HOME HEALTH CARE SERVICE OVERVIEW

Home health care providers offer skilled nursing and personal care services to eligible individuals at home. These services can include:

Skilled nursing (e.g., wound care, medication management)
Physical, occupational, and speech therapy
Personal support (e.g., bathing, dressing, toileting)
Homemaker services (e.g., light housekeeping, laundry)
Care coordination and case management
Telehealth support and monitoring

Services must be ordered by a physician and align with the individual’s plan of care or person-centered service plan (PCSP) under HCBS Waivers.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business entity with the Maine Secretary of State
Obtain EIN and Type 2 NPI
Apply for a Home Health Agency (HHA) license through the Division of Licensing and Certification
Obtain Medicaid Provider Enrollment through MaineCare (via the Health PAS Online Portal)
Submit proof of liability insurance, policies, and staff credentials
Meet staffing, documentation, and training requirements outlined in state regulations

4. MAINECARE ENROLLMENT & SECTION WAIVER PARTICIPATION

Step 1: Prepare Business and Clinical Documents

Organizational chart, policies and procedures, HIPAA policies
Staff licensure and background checks

Step 2: Apply for HHA License via DLC

Submit HHA application with applicable fees and documentation
Prepare for an on-site survey if required

Step 3: Enroll with MaineCare

Create an account on Health PAS Online
Complete provider enrollment for relevant sections (e.g., Section 19, Section 40)
Upload supporting documents, including state license and certifications

Step 4: Begin Service Delivery upon Approval

Accept referrals through case managers and discharge planners
Deliver care as outlined in approved plans

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC certificate
IRS EIN Letter and NPI confirmation
HHA license issued by the Division of Licensing and Certification
Approved MaineCare provider enrollment
Policy & procedure manual including:
- Plan of care templates and physician orders
- Incident reporting and medication logs
- Infection control and emergency response plans
- Client rights and grievance procedures
- Staff credentials, orientation materials, and training logs

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)

Requirements: Maine RN license, CPR certification, experience in home health or geriatrics

Role: Home Health Aide (HHA)

Requirements: CNA license or HHA training, supervision by RN, background check

Role: Therapist (PT/OT/ST)

Requirements: Maine license in specialty, experience in community-based rehab

Training Requirements for All Staff:

HIPAA and infection control
Home safety and client rights
Emergency procedures and documentation standards
Annual continuing education

7. MEDICAID WAIVER SERVICES

Home Health Care is funded through:

MaineCare Section 40: Home Health Services
MaineCare Section 19: Elderly and Adults with Disabilities Waiver
MaineCare Section 96: Private Duty Nursing
Medicare (Part A) for skilled care after hospital discharge
Veterans Administration (VA) benefits for eligible veterans

Approved providers may deliver:

Nursing and therapy services
ADL assistance and caregiver training
Case coordination and outcome documentation
24-hour on-call support (as required by licensure)

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 1–2 weeks

Phase: State Licensure Application (HHA)

Timeline: 30–90 days (may include on-site inspection)

Phase: MaineCare Enrollment

Timeline: 30–60 days after licensure approval

Phase: Staff Onboarding and System Setup

Timeline: 2–4 weeks

Phase: Referral Activation and Billing Setup

Timeline: Ongoing

9. CONTACT INFORMATION

Maine Division of Licensing and Certification

Website: https://www.maine.gov/dhhs/dlc

Phone: (207) 287-9300

Office of MaineCare Services

Email: provider-enrollment@mainecare.maine.gov

Website: https://www.maine.gov/dhhs/oms

Health PAS Online Portal (MaineCare Enrollment)

Website: https://mainecare.maine.gov

Maine Board of Nursing

Website: https://www.maine.gov/boardofnursing

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MAINE HOME HEALTH PROVIDER LAUNCH

We help nurses, therapists, and healthcare entrepreneurs establish fully licensed, Medicaid-approved Home Health Agencies in Maine, with support for compliance, credentialing, and operational success.

Scope of Work: