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Elizabeth M. Whitehorn, Director

Provider Notice Issued 07/12/2022

​Date:   July 12, 2022

To:       Long Term Care Facilities - Nursing Facilities (NF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID); and Psychiatric Residential Treatment Facilities (PRTFs)

Re:      Medicaid 1135 Alternative Settings Waiver Is Discontinued

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This notice informs providers that the Medicaid 1135 Alternative Settings Waiver has been discontinued.

Under the Medicaid alternative settings waiver, the federal Centers for Medicare & Medicaid Services (CMS) has allowed facilities, including nursing facilities (NFs), intermediate care facilities for individuals with intellectual and developmental disabilities (ICF/IDDs), and psychiatric residential treatment facilities (PRTFs), to be fully reimbursed for services rendered in an unlicensed facility where the placing facility continued to render services, provided the state made a reasonable assessment that the facility met minimum standards to ensure the health, safety, and comfort of Medicaid customers and staff. CMS terminated this authority on June 6, 2022.

Providers can request an individual 1135 Alternate Settings Waiver beyond June 6, 2022, if local conditions necessitate additional flexibility. Provider requests can be submitted to federal CMS by completing the following form: CMS 1135 Waiver / Flexibility Request and Inquiry Form - CMS 1135 Form. The federal CMS Center for Clinical Standards and Quality will review individual provider requests and make determinations on a case-by-case basis. 

Questions regarding this notice may be directed to the Bureau of Long Term Care at 844-528-8444.

 
Kelly Cunningham, Administrator
Division of Medical Programs