Maine
LLC
Website link to register:
https://www.maine.gov/sos/cec/corp
Naming conventions
Must not suggest illegal activity or affiliations. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” PLLCs are required for medical professionals.
Licensing Requirements
All members must hold valid medical licenses from the Maine Board of Licensure in Medicine. Malpractice insurance required. Additional certifications for specialized care, such as mental health, may apply.
Required documentation for medical practices
Articles of Organization, Operating Agreement, Maine Health Codes Compliance, Professional Licenses
Filing Fee: $175
Annual/Biennial Fee: $85
Additional Notes: Annual report due June 1.
Medicaid
Program Name: MaineCare
Official Website: https://www.maine.gov/dhhs/oms
Legislation: Maine does not have specific DPC legislation; practices operate under general healthcare and insurance laws.
Private Contracting
Permitted; DPC practices must ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is required.
Medicaid Program
MaineCare provides Medicaid coverage to eligible low-income residents, including children.
Notification Requirements
Notification strongly recommended for Medicaid patient clarity.
Provider Enrollment Requirements
Providers must enroll with MaineCare to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as Medicaid-designated PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly outlined.
CMS Guidance
CMS encourages streamlined enrollment for non-billing providers.
Opportunities for Collaboration
Potential collaboration with Medicaid Managed Care Organizations (MCOs) or participation in state healthcare initiatives.
State-Specific Notes
Collaboration opportunities exist with MaineCare for expanding access to primary care.
Dispensing Medication
Board of Pharmacy Official Link:
https://www.maine.gov/pfr/professionallicensing/professions/board-pharmacy
State Licensing
Physicians must register with the Maine Board of Pharmacy to dispense medications and controlled substances.
Scope of Practice
Dispensing medications is allowed; controlled substances require additional DEA and state registrations.
Inventory Management
Accurate inventory management and secure storage are mandatory for all dispensed medications.
Record-Keeping
Records must comply with Maine state and federal HIPAA regulations.
Dispensing Standards
Labels must meet Maine Board of Pharmacy standards, including patient name, prescribing details, and dosage.
Controlled Substances
DEA registration and mandatory reporting to Maine’s PMP are required for controlled substances.
Billing and Reimbursement
Billing practices must follow federal anti-kickback laws and state-specific requirements.
Federal Compliance
Physicians must adhere to federal and Maine-specific compliance regulations.
State Pharmacy Laws
Registration with the Maine Board of Pharmacy is required for dispensing controlled substances.
Patient Consent
Patient consent must be obtained prior to dispensing medications.
Insurance and Liability
Physicians must ensure liability insurance covers risks associated with dispensing practices.
Training Requirements
Continuing education for controlled substances is encouraged under Maine law.
Audits and Inspections
Inspections are conducted by the Maine Board of Pharmacy to ensure compliance with dispensing regulations.