Reminder: Home and Community Based Services (HCBS) Compliance Form Instructions for Waiver Services Provider

Jan 26, 2024

The State requires all providers who deliver services under Sections 18, 20, 21, and 29 fill out a HCBS Compliance Form. Providers delivering HCBS services under the above sections of policy who are submitting new, revalidating, reactivating, and maintenance cases must fill out the form and upload it before the case can be finalized. This will ensure that providers of HCBS waiver services are in compliance with applicable requirements for HCBS waiver settings.

Providers should follow the instructions on the HCBS Compliance Form to ensure everything is filled out properly. Please ensure that all boxes under sections A, B, and C are filled out with the appropriate information. Nothing should be left blank. This will avoid any MaineCare enrollment case getting sent back to the provider for corrections. Please be sure to use the Provider’s mailing or physical address when the form asks for an “Address”. Also make sure the “Setting Address” corresponds exactly to the NPI + 3 (Service Location’s) physical address.    

Note: If you are a provider who is currently working on compliance and are not ready to submit the new HCBS form, you can submit the Notice of Decision -- which is an automated message from the HCBS Compliance Portal.  

If you have questions, contact Olivia Hardman your Provider Relations Specialist.