End of Section 1915(c) Waiver Appendix K Flexibilities

Oct 20, 2023

In response to the federal Public Health Emergency (PHE), Maine established temporary changes to its five existing federally approved 1915(c) home and community-based waivers through a standalone Appendix K: Emergency Preparedness and Response amendment. 

As previously shared in our October 16, 2023, provider bulletin, Appendix K flexibilities for Sections 19 and 20 will end on November 11, 2023. Appendix K flexibilities related to Sections 18, 21, and 29 are extended until such time as CMS approves the submitted 1915(c) waiver amendment applications. 

Today, October 20, 2023, MaineCare uploaded Appendix K Flexibility Guidance for Sections 19 and 20 to the COVID-19 and End of PHE webpage. This document addresses which Appendix K flexibilities are continuing as permanent provisions, as well as those set to expire on November 11, 2023.

Additionally, the Department is conducting a full redetermination of eligibility for all MaineCare members, a process known as the “unwinding” of the continuous coverage requirement. For more information, please refer to General Information for Providers Regarding the End of the Public Health Emergency, published April 25, 2023. If a MaineCare member is seeking PHE Unwinding information, please direct them to the Unwinding webpage at www.mainecare.gov/unwinding.

We will continue to update our webpage with resources and current information concerning the end of the PHE and related flexibilities. Additional e-messages will be sent over the coming weeks as information becomes available. In the meantime, please send questions related to the end of the PHE and Appendix K to DHHSMaineCareEndofPHE@maine.gov. 

In accordance with federal law and the MaineCare Benefits Manual, the Department must give members the opportunity for a hearing if requested 1) When their service request is denied or takes too long to be processed or 2) the member believes the Department made a mistake stopping, reducing, or suspending their medical eligibility or covered services.