Attention All MaineCare Providers: Updated Alternative Settings Guidance  

May 12, 2022

Under the Department’s approved Section 1135 waiver, the Centers for Medicare & Medicaid Services (CMS) has granted us the ability to waive certain federal Medicaid requirements during the COVID-19 federal public health emergency. This has helped ensure that MaineCare members have access to necessary health care services and that providers have the flexibility and support necessary to meet their needs. Under this waiver, CMS had approved the use of temporary service locations (“Alternative Settings”). CMS is now ending all states’ authority to approve Alternative Settings under 1135 waiver authority effective June 6, 2022. 

In order to meet this deadline, the Department will no longer accept or approve any new requests for Alternative Settings under 1135 waiver authority, effective immediately. We have updated our Alternative Settings guidance to reflect this change.  

In addition, the Department will be ending all existing approvals for Alternative Settings effective June 6, 2022. Any provider who has an approved Alternative Setting must stop using that setting by that date or enroll that setting as a new service location through the standard MaineCare provider enrollment process prior to June 6, 2022. See the Provider Maintenance User Guide for instructions to enroll a new service location. We urge providers to contact the Department with any questions or concerns about ending their use of an Alternative Setting or for assistance with transitioning any members affected by this change to another setting. Department contacts are listed in the Alternative Settings Guidance. The Department cannot reimburse providers who deliver services at unenrolled Alternative Setting locations after June 6, 2022. 

The end of 1135 authority for Alternative Settings will not affect any settings that have been approved or might be approved in the future under other authority, such as Appendix K for Home and Community Based Waiver providers. If a provider has any questions about the authority it is operating an alternative setting under, they should contact the appropriate contact person identified in the Alternative Settings Guidance or your Provider Relations Specialist.