Accountable Care Organization

Provider Resources

COVID-19 Payer Policies & Information

Below are the links to payer information including coding, waivers for member cost shares on diagnostic testing and telemedicine visits, opening crisis response lines and expanding 24/7 access to nurse medical lines.

Aetna: Payer link

Anthem: Payer link

Centers for Medicare & Medicaid Services (CMS): Payer link

Cigna: Payer link

Community Health OptionsPayer link

Harvard Pilgrim: Payer link

Humana: Payer link

Martin's Point Generations Advantage: Payer link

Martin's Point USFHP: Payer link

Medicaid (MaineCare) and the Children’s Health Insurance Program (CHIP): Payer link

United Healthcare: Payer link

WellCare: Payer link

Resource Topics

Providers are eligible to participate in the ACO who are a MD, DO or Primary Care NP and a member of the medical staff of Franklin Memorial Hospital, LincolnHealth, Maine Medical Center, Memorial Hospital, Mid Coast Hospital, Pen Bay Medical Center, Southern Maine Health Care, Stephens Memorial Hospital, St. Mary’s Regional Medical Center or Waldo County General Hospital. To begin the process of joining the MaineHealth ACO, please email us to request an application packet.


Annual Compliance Training Documents

Compliance and Privacy Manual Policies

Beneficiary Information Notice
Beneficiary Information Notice without Portal
Voluntary Alignment Fact Sheet with Instructions for Beneficiaries (English)
Voluntary Alignment Fact Sheet with Instructions for Beneficiaries (Spanish)
Voluntary Alignment Fact Sheet for Practice Staff
Office Poster 8.5x14 (PDF)
Office Poster 8.5x14 without Portal (PDF)

Coding Documents

Key Measures

Practices that participate in the ACO's MSSP contract are automatically enrolled in a special MIPS payment model created for ACO participants called the MIPS APM. Because the ACO reports some categories of data on behalf of its participants, this model places a reduced reporting burden on practices, compared to those enrolled in the standard MIPS model. Specifically, the ACO reports Quality data for MIPS and MSSP, Cost is not scored, and MIPS APM participants receive full credit for Improvement Activities.

Promoting Interoperability (PI) - Each ACO participant TIN (tax ID number) is required to report for the Promoting Interoperability (PI) category, or apply for and receive a hardship exception from CMS. Beginning in 2022 the Small Practice exception became an automatic exception (no application required). Definition of small practice is practice or clinician with 15 or fewer clinicians billing under the practice’s TIN. NEW EHR requirements for 2023: MIPS reporters must attest to CEHRT certified to the 2015 Edition Cures Update: 2015 Edition Cures Update CEHRT functionality must be in place by the first day of your MIPS Promoting Interoperability performance period and your EHR must be certified by ONC to the 2015 Edition Cures Update CEHRT criteria by the last day of your performance period. You will need to provide your EHR’s CMS identification code from the Certified Health IT Product List (CHPL), available, when you submit your data. We suggest working directly with your HIT / EHR vendor to ensure their compliance plans.

For more information:

MIPS Promoting Interoperability Requirements

Participants must submit collected data for specific measures from each of the 4 objectives (unless an exclusion is claimed) for 90 continuous days or more during 2020:

  1. e-Prescribing
  2. Health Information Exchange
  3. Provider to Patient Exchange
  4. Public Health and Clinical Data Exchange 

Measure Specifications


Health Information Exchange

Provider to Patient Exchange

Public Health and Clinical Data Exchange

Attestations Required but Not Scored

Security Risk Analysis: must conduct on 2015 CEHRT on an annual basis - SUBMIT YES

Actions to Limit or Restrict Interoperability of CEHRT: acted in good faith and took necessary steps to prevent limiting or restricting the compatibility or interoperability of CEHRT - SUBMIT YESONC (Office of the National Coordinator for Health Information Technology)

Direct Review Attestation: assent to federal government audit - SUBMIT YES

Safety Assurance Factors for EHR Resilience (SAFER) Guides measure

HARP (HCQIS access roles and profile system) Account Information

The Quality Payment Program (QPP) portal requires you to have a login and password. If you already have a HARP account / QPP login you may continue to use it. If you do not have an account, please follow the process outlined in the documents below.

  1. Register for a HARP Account
  2. Connect to an Organization
  3. Connect as a Clinician
  4. Security Officials Manage Access
  5. QPP Access at a Glance

If you have any questions, please contact Emily Levi,

ACO Careers

Join us! The MaineHealth Accountable Care Organization is hiring. Click to view and apply for open positions.