Maine's Office of MaineCare Services has put intermediate care facilities for individuals with intellectual disabilities on its list of rate reviews to start in 2027. The department's draft schedule, presented to its rate reform advisory panel on Oct. 30, lists the last completed rate review for these homes (Section 50 of the MaineCare Benefits Manual) as "pre-statute," meaning before Maine's rate reform law took effect.

The public can comment on the draft until 5 p.m. on Nov. 24.

What the draft schedule says

Under 22 M.R.S.A. §3173-J, the Department of Health and Human Services must build a rate determination schedule each year with its MaineCare Rate Reform Expert Technical Advisory Panel, post it, take public comment and publish a summary of the comments. The same law requires a rate determination for each section of MaineCare policy at least once every five years.

The draft calendar year 2027 schedule splits work into two groups:

  • Carried over from 2026. A group of home and community-based services rates, covering clinical, therapy, care coordination, supportive skills building, assistive technology and personal support services across Sections 12, 18, 19, 20, 21, 29, 40, 96 and 102. The department expects this work to finish by the end of 2026.
  • New starts in 2027. ICF/IID (Section 50) is one of 20 sections set to begin review, alongside nursing facilities, physician services, therapies, ambulance and pharmacy ingredient costs.

The panel presentation says rate determinations for HCBS serving people with intellectual and developmental disabilities or autism and the Lifespan waiver (Sections 18, 20, 21, 29 and 24) were completed in 2026. It says 38 sections of MaineCare policy have been through a rate determination so far, and that the 2027 calendar "reflects mostly the remaining work" to finish the first five-year cycle under the law.

A rate study is not a rate increase

The department stresses that setting a rate and paying it are separate steps. A rate determination identifies what a service should cost; appropriations from the Legislature are needed before new rates take effect, and rulemaking or federal approval may also be required.

Changes made by Public Law 2025, chapter 664, add some visibility to that gap. Since July 2026, the department must report the overall fiscal cost of putting a rate determination in place when it finishes one. The law also now requires an annual report on the cost of full cost-of-living adjustments.

For services where direct care staffing drives most of the cost, the statute ties the cost-of-living adjustment to the one applied to Maine's minimum wage. It requires the department to apply that adjustment to services delivered by essential support workers and, for services adjusted to match the minimum wage increase, to apply it between six and 12 months after the minimum wage goes up. The department must post the estimated cost of the next year's adjustments by Jan. 1.

The presentation also notes that federal Medicaid eligibility changes under H.R. 1 did not change the 2027 priorities but do affect the department's capacity to carry out its plans.

Key dates

  • Nov. 3: The draft schedule goes to the MaineCare Advisory Committee.
  • Nov. 24, 5 p.m.: Written comments are due by email to RateReform.OMS@maine.gov, with "CY27 Schedule" in the subject line.
  • Dec. 15: The department plans to publish the final 2027 schedule and a summary of comments.

The department posts bimonthly progress reports on rate determinations on its MaineCare Rate System Reform page.

What this means for providers and DSPs

For ICF/IID operators, a 2027 start opens the first review of how these homes are paid since the rate law passed. The statute requires public notice when a rate determination begins. When the department does a full rate study, it collects provider cost data through cost reports and surveys, convenes a meeting where providers and the public can comment on its recommendations, and responds in writing to those comments. Agencies that want their staffing costs counted should be ready to share wage, benefit and staffing data when the review opens.

For HCBS provider agencies, the carried-over review of clinical, care coordination, skills building and personal support rates is the one to watch before year's end. Any new rates still depend on legislative funding.

For direct support professionals, the link between MaineCare rates and the minimum wage matters most. The law's six-to-12-month lag means rate increases tied to a minimum wage hike can arrive well after the new wage floor takes effect, which can squeeze agency budgets in the meantime.

The comment period on the schedule itself is a chance for agencies, families and workers to argue for moving a service up the list, especially where access problems exist. The law requires the department to explain how the date of the last review and any access issues shaped the schedule.