How to start a hospice in Maine

Maine requires a Hospice provider license (provisional, then full or conditional) from Maine Department of Health and Human Services, Division of Licensing and Certification to operate a hospice. Fee: $200.

License required

Yes

License

Hospice provider license (provisional, then full or conditional)

Issuing agency

Maine Department of Health and Human Services, Division of Licensing and Certification

Fee

$200

Fee details

$200 with each initial application; thereafter a $200 annual fee; $200 application fee for a new owner. Fees are not refundable.

Renewal

The rule says licenses are renewed every two years on payment of the fee, while also assessing a $200 annual fee; the Department sends a renewal application at least 50 days before expiration and it is due 20 days before expiration.

Survey and inspection

Applying gives consent to surveys; a hospice is not eligible for licensure or renewal unless it has had a Medicare or state licensure survey within the previous three years.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

10-144 C.M.R. Chapter 120, Regulations Governing the Licensing and Functioning of Hospice Programs

1. Submit the initial application with the $200 fee
2. Receive a provisional license after applying and paying
3. Pass the Department's on-site review to receive a full or conditional license
4. Keep a Medicare or state licensure survey within the prior 3 years to stay eligible for renewal
5. Return the renewal application at least 20 days before the license expires

Program

MaineCare (Office of MaineCare Services, Maine DHHS)

Enrollment portal

MIHMS Health PAS Online Portal — Provider Enrollment Application (PEA) via Trading Partner Account (moving to the new 'MaineCare Partner Portal' in late September 2026)

Fiscal agent

Gainwell Technologies (MaineCare provider enrollment vendor/MIHMS)

Application fee

MaineCare charges the fee to providers that are newly enrolling, revalidating or adding a practice location, unless exempt, paid by debit or credit card in the Trading Partner Account; its fee spreadsheet lists the provider types that pay. Home health agencies and DME suppliers must also post a surety bond at enrollment, revalidation and new locations. Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

MaineCare runs automated criminal history checks on all providers and on 5%+ owners, board members, managing employees and rendering providers. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

MaineCare does site visits on revalidating provider locations assigned moderate or high risk; risk is set by provider type and service-location specialty (Risk Category Assignments, May 2024). Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

MaineCare revalidates at least every five years (every three years for DME providers) or whenever it asks; it has a federally required 2026-2028 off-cycle revalidation plan. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Maine Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need (Maine Certificate of Need Act of 2002)

Agency

Maine Department of Health and Human Services (CON Unit, Division of Licensing and Certification)

Services covered

• hospitals and psychiatric hospitals
• nursing facilities
• kidney disease treatment centers / freestanding hemodialysis
• rehabilitation facilities
• ambulatory surgical facilities
• independent radiological service centers
• independent cardiac catheterization centers
• cancer treatment centers
• transfers of ownership or control of a health care facility
• major medical equipment acquisitions

Maine certificate of need details →

State minimum wage

$15.10 an hour

Effective

2026-01-01

Scheduled increases

Rises to $15.70 on 2027-01-01 (CPI-W Northeast indexing).

Direct-care wage floor

MaineCare and state-funded reimbursement for essential support workers must build in at least 125% of the state minimum wage for the labor portion of the rate, plus related taxes and benefits, updated whenever the minimum wage rises (in effect since 2022-01-01). This is a rate floor, not a direct wage mandate on employers.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Hospice agencies (community based) — active organization NPIs (NPPES)

36 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

17 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

327,698 (as of Jun 1, 2026)

All Maine Hospice Medicaid rates, ranked →