Attention Hospital Providers: Alternative Settings Guidance Clarification

May 31, 2022

The Office of MaineCare Services (OMS) sent a e-message on May 12, 2022, notifying providers that we are ending Alternative Settings flexibility effective June 6, 2022, as the Centers for Medicare & Medicaid Services (CMS) is terminating state Medicaid agencies’ authority as of that date to approve Alternative Settings under 1135 waiver authority. We are providing the following clarification on how this change intersects with the ability of the Division of Licensing and Certification (DLC) to license temporary alternative care sites.  

The ending of MaineCare’s 1135 waiver authority for Alternative Settings does not affect DLC’s ability to approve and license temporary alternative care sites for hospitals. Hospitals can still add temporary alternative care sites to their hospital license through the licensing process that has been in place for the past two years.   

However, MaineCare will no longer be able to reimburse a hospital for services delivered at an unenrolled location after June 6, 2022. Therefore, hospital providers must add any approved temporary alternative care sites as new service locations under their MaineCare enrollment to bill and receive reimbursement after June 6, 2022. If a temporary alternative care site is already enrolled with MaineCare, no enrollment action is required.  

Please contact Marcia Smith with any questions related to the licensing of temporary alternative care sites, which DLC outlined in its April 29, 2020 response to the CMS waivers applicability under State Licensing Rule. 

Please contact Aaron Fotter with any questions related to the enrollment of a temporary alternative care site with MaineCare.