PRIORITY – Certified Seed Forms for Mainecare


TO: Superintendent of Schools, Business Managers, CDS Regional Boards of Directors, CDS Regional Site Directors
FROM: Angela Faherty, Ph.D., Commissioner of Education
DATE: October 1, 2010
RE: PRIORITY – Certified Seed Forms for Mainecare

On a yearly basis, CDS regional sites and school administrative units need to complete certified seed forms for the Department of Health and Human Services Mainecare program. The Department of Health and Human Services is implementing a new data system as of September 1, 2010. The Certified seed form covering September 1, 2010 to June 30, 2011 must be completed by all school administrative units(SAUs) in order for SAUs to receive reimbursement.

Form Covering September 1, 2010 to June 30, 2011
The form can be accessed at:
The following instructions for completing this form were developed by Mainecare, are replicated here and are contained on the Certified Public Expenditures Agreement form.

This  form only applies to providers enrolled in MIHMS under the following provider types:
87 – Public School
88 – Special Purpose Private School
89 – Intermediate Education Unit
90 – Government Agency

I.) You will need to complete a separate form for each NPI number and/or service location ID that you have enrolled in MIHMS.
When it asks for the service location ID for any applicable locations of the Provider, these numbers should have been provided to you in the welcome letter upon enrollment in MIHMS.

II.) The Certified Seed Amount is the amount of your special education budget that pertains to services provided to Mainecare eligible clients/students.

Attention Schools!
A simple calculation for this would be to subtract out any personnel or building related costs from your special education budget, then take that number and multiply it by the percentage of students you know to be Mainecare eligible to get your final seed number.

III.) Have an authorized official, i.e. superintendent, director, certify the funds by providing their name, title, signature and the date.

IV.) Finally, fax the form to the number provided.”

Please fax the form directly to Mainecare at 1-877-314-8776.

If you have questions, please call Jaci Holmes, Federal State Legislative Liaison at 624-6669.

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