Jails, prisons can bill MaineCare for some clinical services, including addiction treatment
Maine’s county jails and prisons are set to receive significant financial relief for inmate healthcare services, following the federal approval of a waiver that allows them to bill the state’s Medicaid program, MaineCare, for certain treatments. This development, announced by the Centers for Medicaid and Medicare Services (CMS), marks a shift from the current system where correctional facilities must cover the costs of mandated services out of their own budgets.
The waiver enables jails to bill MaineCare for clinical services provided to individuals up to 60 days before their expected release date. Covered services include medication-assisted treatment for substance use disorders, physical and behavioral health case management, care for HIV and hepatitis C, family planning services, diagnostic testing, and a 30-day supply of prescription medications upon release. This initiative is expected to alleviate the financial strain on counties, which have been grappling with the costs since a 2019 court ruling required them to provide medication-assisted treatment without state reimbursement.
Androscoggin County Sheriff Eric Samson, whose facility in Auburn has been preparing for this change since 2024, expressed cautious optimism. “It should provide savings due to the reimbursement, but until we get this implemented, we won’t know how advantageous it is. But it should provide some relief financially,” Samson said. He noted that his department has been collaborating with federal and state agencies to ensure a smooth rollout, with Androscoggin County Jail anticipated to be among the first to adopt the new billing system.
The financial impact is substantial. According to a January 2026 report from the Maine County Corrections Professional Standards Council, counties spent over $12.6 million on medication-assisted treatment and mental health services across 15 correctional facilities in the previous year. This waiver is seen as a critical step in addressing the rising costs that have pressured local budgets, ultimately affecting towns and cities that fund the jails.
MaineCare officials stated that billing for these services will commence on July 1, 2028. The rollout will prioritize counties that are most prepared to implement the new system, with the goal of expanding access over time. This move is expected to enhance the continuity of care for incarcerated individuals, improving their transition back into the community while easing the fiscal burden on correctional facilities.
