how to become a medicaid waiver provider in georgia

Applications are accepted by DCH in March and September of each year. As a general rule of thumb, in 2022, senior applicants for a HCBS Waiver are limited to $2,523 / month in income and $2,000 in assets. Each program offers several "core" services: Additional services are available under each program. . NPIs are issued through the National Plan & Provider Enumeration System (NPPES). endobj HVn0+ T(e(8AF-~,%YvA$w3$, 'Yghj4Ska8}"]|&3Qb9W;RN5 5[1f}Mt2e63Q6l2IQXPe|I7BrQ.F48+'9]gs; This information is located on the Georgia Medicaid Management Information System (GAMMIS) website at: https://www.mmis.georgia.gov/portal/PubAccess.Provider%20Information/Provider%20Manuals/tabId/54/Default.aspx. xB++EG?^5C5_L(jXbgmm $oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$oM$uuM4Vet,[:ir[=CV.)iYu\SR[p"Z]ZIvir&1{Nd.9m]ZIvir&1{Nd.9m]ZIvir&1{N wC9.!lU%7]s!9:~aRM(pf,}lUd#1aN6wSF7p2f)LLe!5l|='+H$ef (click to hide)Alert Message posted 3/27/2020, Skip to Provider Enrollment Subsystem Menu. The CCSP Provider Consult is not a general information session. See, for example, Adena Regional Medical Center v. ). A list of the applicable manuals is below. Use this guide if any of the following apply: If you already have an NPI, skip this step and proceed to Step 2. To be eligible for NOW or COMP Medicaid Waiver services, a person must have an intellectual disability - or a closely related developmental disability, such as autism, cerebral palsy, or epilepsy - which substantially impairs intellectual or adaptive functioning. Intellectual & Developmental Disabilities, Applications for New & Existing Providers, Improving Health Outcomes Initiative Collaborative Learning Center, How to Report a Concern or Complaint about the Quality of Care or Safety. Per DCH policy you must wait one (1) year before submitting another application. An official website of the State of Georgia. {UQ2R`%c`VT:dpCU2T_(Fd$+*JFzd JFbJFfdJF:dC C0\ U3:dw!#hYD8C"L "DFV%2*UG`p=FQ1jf*DW!ru^=W1^Ipl7 .(6D!,M|YK` Once the DBHDD application, and if applicable, the site visit is approved, you will be notified to complete the online application for the Department of Community Health (DCH). obtain a clear understanding of this Medicaid Waiver. Care Waiver Program (ICWP) Contact Your MAC (PDF). Services must be recommended by a licensed physician or other licensed practitioner of the healing arts acting within their scope of practice under state law to prevent the progression of ASD, prolong life, and promote the physical and mental health of the individual. zi>n[q@. We're here to help. You will submit either the I/DD or BH Agency Provider Letter of Intent (LOI) or I/DD Individual Provider LOI during the applicable open enrollment period. As an interested BH provider, you will find it helpful to review the Medicaid Provider Manual for Behavioral Health Services on the GAMMIS website at the following link:https://www.mmis.georgia.gov/portal/PubAccess.Provider%20Information/Provider%20Manuals/tabId/54/Default.aspx. Enhanced case management service is available to individuals who require coordination and oversight through a primary care physician as part of the team. Waiver programs help people who are elderly or have disabilities and need help to live in their home or community instead of an institution such as a nursing home or intermediate care facility for people with intellectual or developmental disabilities. The Provider Enrollment Unit enrolls qualified providers to receive Medicaid reimbursement for services rendered lock Visit the DCH waivers webpage at: https://dch.georgia.gov/waivers September 2017 Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404 . This guide will help you enroll in three steps. The Program Specialist may occasionally send Banner messages through web portal for important notifications. HVKo8WH(K@Q E]n=j/8jCdYi)f7B For instructions and forms related to provider enrollment, access the Enrollment Forms page under the Provider Enrollment menu. An official website of the State of Georgia. Senior Community Service Employment Program (SCSEP), About Abuse, Neglect, and Exploitation of At-Risk Adults, Georgia Alzheimer's Disease & Related Dementias State Plan, Facebook page for Division of Aging Services | Georgia Department of Human Services, Twitter page for Division of Aging Services | Georgia Department of Human Services, Linkedin page for Division of Aging Services | Georgia Department of Human Services, YouTube page for Division of Aging Services | Georgia Department of Human Services. %PDF-1.5 % Waiver programs help people who are elderly or have disabilities and need help to live in their home or community instead of an institution such as a nursing home or ICF-MR. On July 14, 2022, the Centers for Medicare and Medicaid Services notified DCH of its approval for 1915(c) Comprehensive Supports Waiver renewal for individuals with intellectual and/or developmental disabilities. Before sharing sensitive or personal information, make sure youre on an official state website. Enroll using PECOS,i the online Medicare enrollment system. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. The Provider Enrollment Unit can be reached at the following: In response to the Centers for Medicare & Medicaid Services (CMS) approval of Medicaid Section 1135 Waivers for COVID-19, the State of Georgia Department of Community Health will expedite new enrollment applications until further notice. Before sharing sensitive or personal information, make sure youre on an official state website. Medicare is a federal program. h]|;nO73xiKD9 &t&|4>F3 Hd""W;S|i~00T|Attq{pcE^kTuU"c`rwLfT|HLn q. If the DCH application is approved, DBHDD will notify you via an email communication of your approval as either a BH or I/DD Provider. Providers wanting to enroll in the Georgia Medicaid program can easily do so online using the Enrollment Wizard found within the Provider Enrollment menu. You can decide how often to receive updates. Applications are accepted by DCH in March and September of each year. 08&@}68O`0YuL &DR V-cSDm c1YeSX@rT:dPaLup9CU2C' ^U:d! Offers services for individuals with intellectual and/or developmental disabilities who require an intermediate care facility. Learn more Apply for Service Options Using Resources in a Community Environment (SOURCE) <> hb`````f`f`0 |@1 h``ZPxjGd`8H 1/H92i? Initial Spending Plan Projection and Narrative for the ARPA10% point increase in FMAP for HCBS. . Interested applicants must begin the process again at Phase 1, step 1 in a subsequent enrollment period at least one (1) year after the denial decision. Send a Message. This program is available for eligible Medicaid members who are severely physically disabled and between the ages of 21 and 64 when they apply. to complete the registration (select the date you would like to attend in the drop-down box at the top). Apply for Medicaid Medicaid has several programs that can help you or your family. Office of Analytics and Program Improvement, Medicaid Promoting Interoperability Program. Medicaid provides access to free and low-cost medical care in Georgia. <> State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. access the NOW Draft Application click here. Emergency Number: For emergency mental health, developmental disability or addictive disease services, call: Georgia Crisis & Access Line: 1-800-715-4225 Not sure if you have an NPI? Medicaid. For details about this waiver renewal, Waiver ;e_\7b%A6q%Phzp'|gToI1]si NpQ,*uqx:JjvL}AjU+qi,. The Medicaid program canand does (through Medicaid DSH payments)subsidize the treatment of low-income, uninsured patients without making those individuals eligible for "medical assistance," as that phrase is used in the statute. J0xhcni).P~EJRt l ^E`>XBI!_~ If the DCH application is approved, DBHDD will notify you via an email communication of your approval as either a BH or I/DD Provider. All new providers are required to submit a completed DDA Medicaid Waiver Provider Application and submit the required supporting documentation in the form of policies and procedures, licensure and/or certification that demonstrates the provider agency's compliance with the specific rules for each of the waiver services the provider agency is Another option for frail, elderly, and disabled Georgians that provides coordinated services in their home or community. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. Local, state, and federal government websites often end in .gov. endstream endobj 188 0 obj <>stream Links to the public notices and draft waiver applications are listed below. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Try not to admit members until you have an understanding of ICWP The ICWP Policy is updated quarterly. Contact Medicaid Care Management Organizations (CMOs), File a Complaint about a Licensed Facility, Facebook page for Georgia Department of Community Health, Twitter page for Georgia Department of Community Health, Linkedin page for Georgia Department of Community Health, YouTube page for Georgia Department of Community Health, GA Partial Approval Letter (HCBS Initial Spending Plan), Medicaid Sign-Up Portal (Georgia Gateway). Primary: (404) 657-5468. To avoid having your Medicare billing privileges revoked, be sure to report the following changes within 30 days: You must report all other changes within 90 days. Eligibility for ICWP is based on either a nursing facility or hospital level of care for adults with severe physical disabilities or traumatic brain injury (TBI). 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Medicare Enrollment Assistance & Contacts, Medicare Enrollment Guide for Institutional Providers, MLN Enrollment Webcast Presentation: MultiFactor Authentication for I&A System (PDF), MLN Enrollment Webcast Transcript: Multi-Factor Authentication for I&A System (PDF), Medicare Enrollment Contractor Contact List (PDF), Tips to Facilitate the Medicare Enrollment Process (PDF), Medicare Provider-Supplier Enrollment National Education Products (PDF), National Provider Identifier Standard (NPI), MLN Enrollment Webcast Audio Transcript: Multi-Factor Authentication for I&A System, Annual Medicare Participation Announcement, Youre an institutional provider. l`JV``X I. To apply for services in either program, contact the Georgia Aging and Disability Resource Connections(ADRC). The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) provides day-to-day operations in these programs through six regional field offices. <> Call Us. "xG^FZh;O8\iy^0AFeE#~-aB _mh K)Z3r >oT->+ L}$\ZSypts [}s[pYI._.jJ&*40)|[cPU|9V&=pC~7kj~xcR1>5>)`lB3{jgj|zu_3\O5c\j;2Ft(|5UdC /w.s}7U1242LV.2eH2*M[w+uFA:x7FX8ztjf#;R_kUMFUu2gKa7{=/9v@a*Uj3^ T 9srz>n.QI>dY294? To provide services in other counties, you can find the appropriate AAA at, To sign up for a CCSP Provider Consult, please visit our. Options Waiver Program (NOW) and Comprehensive Supports Waiver Program (COMP), Options Using Resources in a Community Environment (SOURCE, Amendment Application for Georgias Elderly & Disabled Waiver Program, Amendment Application for Comprehensive Supports Waiver Program, Department of Behavioral Health and Developmental DisabilitiesServices, Georgia Aging and Disability Resource Connections, GAPP provider manual on the GAMMIS website, Third Party Liability Services Procurement, Childrens Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Health Insurance Premium Payment Program (HIPP), 2020 Georgia Families 360 Monitoring and Oversight Committee, 2019 Georgia Families 360 Monitoring and Oversight Committee, Georgia Medicaid Electronic Visit Verification, PSS / CLS / Claims Implementation Archive (2018 2021), Georgia Money Follows The Person (Ga MFP), Infant and Early Childhood Behavioral Health Services, Medicaid Enterprise System Transformation (MEST), Non-Emergency Medical Transportation FAQs, Non-Emergency Medical Transportation (NEMT) Procurement, Planning for Healthy Babies Program Overview, Planning For Healthy Babies Annual Reporting, Planning For Healthy Babies Semi-Annual Reporting, Planning For Healthy Babies Quarterly Reporting, Planning For Healthy Babies Summative Evaluation Reporting, Right from the Start Medical Assistance Group, service coordination (help with managing care needs and services), personal support (assistance with daily living activities, i.e. Found in the Elderly & Disabled Waiver Program, the CCSP and SOURCE Programs serve frail elderly and disabled Georgians otherwise eligible under a nursing facility level of care through the provision of case management for service coordination, adult daycare, alternative living services, personal care, home-delivered meals, and respite care for family caregivers. In response to the Centers for Medicare & Medicaid Services (CMS) approval of Medicaid Section 1135 Waivers for COVID-19, the State of Georgia Department of Community Health will expedite new enrollment applications until further notice. However, ARC does provide CCSP Provider Consults for those providers that will provide service in Cherokee, Clayton, Cobb, DeKalb, Douglas, Fayette, Fulton, Gwinnett, Henry, or Rockdale counties. PRvH}+m`\=G7&%/^(Z0XxS{'h2LA)eVPac2*GQrFi0:pNQl+#sWD9; ZzkqkYf|; _%WmW S&~O1: .mrQbO`e1$+-|b&s5A&HpTNG>sYz (V] l{T 3CYNK^oE`!|nyM\,"7FK! bathing, dressing, meals, and housekeeping), home health services (nursing, home health aide, and occupational, physical and speech therapy). User Information PDF Reader Required endobj Heres how you know. Its important to keep your enrollment information up to date. x5j7-Ip/6xH2KYq^_|>!rG /|"=Ng|;P61-o^LuJ-^|x Ilo{YP[o X`g(_;6y~c|Y'CUzWcJ`n?jLuQ N9|7A~B (|8dmc?w-wb_Aba THUa^D>4?:'jg/p|,cgi,mKW\I$S~YNwG5.L-gj9~Q ;0F02 q ?RhA+v5\*k8kqiFyAJ4$g9?H~w(;) Ck{r~i~Y1wyU1X.M C Toll Free: (877) 423-4746. Apply to become a Medicaid Waiver Provider To grow a client base by becoming a CCSP provider, your agency must apply and be approved by the Georgia Department of Community Health (DCH). zoX-8IHH=mhX&Z4&kjI[%w$WTdsalTLbBaCVnPm+E:YYel dadBwi,0>ldbuSUqQ47Z"ZWjU\ES-juSn*TY=#R:EGMs@sxNH.&trZX/fb-SS\i:}%{qjCm"nSkHl$,?z-#=k?zGTHr|&aiR>Z`oNI}c^0jv+Z-+qmN4kGTni@y3zd O'lg[(6+mOK>>a?I/3?.~#cX9y|/I. Medicaid Waiver Population Served/ Eligibility Financial Eligibility Services Provided Wait List Cost Share Case Manager Intake . }~+U#Y7*vv5/k*3SX7s>_M 431@*5V)*MNd xc|DX?2l*;nB6}o94d}p7a{31}wBbyJ8-T H+v For more information on how to apply, visit Georgia's Department of Community Health website. <>>> Click here for help and information about bookmarks. endstream endobj startxref Review the steps outlined below for the process to become an approved DBHDD provider for either Behavioral Health (BH) Services or Intellectual and Developmental Disability (I/DD) Services. This email will contain information regarding New Provider Orientation. https:// . For questions not answered in this Guide, please contact HPES at 1-800-766-4456. www.mmis.georgia.gov Updated 11/28/2011 M\}v4 The DBHDD Provider Enrollment Process is guided by specific DBHDD policies. HVn8}W#YDH endstream Once the LOI has been approved, you will receive an invitation to apply. Providers can also enroll to become a participating provider using the Enrollment Wizard . ; You don't want to bill Medicare for your services, but you do want enroll in Medicare solely to order and certify. The or .gov The waivers allow healthcare professionals to provide care in a person's home or community instead of a long-term care facility. Each state has its own waivers and each waiver, its own policy. <> FAQs Home and Community Services Guide Available, American Rescue Plan Act Initial Spending Plan. The 12 ADRC offices are identified by counties served. means youve safely connected to the .gov website. (xC]`)q6> Call us at 770-458-8500 or contact us to learn more about obtaining personal care or skilled nursing care from one of our compassionate caregivers under the Community Care Services Program. Upon completion of the enrollment process, approved providers are issued a Medicaid provider number and able to participate in the Georgia Medicaid program. Serves frail, elderly, and disabled Georgians by providing coordinated services in their home or community. ( X Providers HCBS Incident Reporting System Medicaid Pharmacy Preferred Drug Lists Provider Forms Provider Types Public Notices . 215 0 obj <>stream This information is located on the Georgia Medicaid Management Information System (GAMMIS) website at:https://www.mmis.georgia.gov/portal/PubAccess.Provider%20Information/Provider%20Manuals/tabId/54/Default.aspx. - Updated 3/10/20. For your convenience, this section of our website was created to centralize information that may be particularly important to you as Medicaid and PeachCare for Kids providers. Many state waivers also offer a single reimbursement of between $40 - $200 intended to cover any installation or startup fees associated with a PERS service. To apply for services in the ICWP, contact Alliant Georgia Medical Care Foundation (GMCF) at 800-982-0411 or 888-669-7195. HP Enterprise Services (HPES) is the Fiscal Agent for Georgia Medicaid. How you know. Department of Human Services, Division of Family and Children Services, Georgia Department of Behavioral Health and Developmental Disabilities. At Health Force of Georgia, we understand the challenges you face taking care of a loved one with needs. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. 0 Email Us. ]v&'0 pHin@ hf9^ Potential Provider Information . ; You wish to provide services to beneficiaries but do not want to bill Medicare for your services. endobj YouTube page for Georgia Medicaid; How can we help? h[j}~tU1cG[J+Vkp>U=JV@`L:]UCp.]@.&r&, Amendment Application for Georgias Elderly & Disabled Waiver Program The Georgia Medicaid Management Information System (GAMMIS) serves as the primary web portal for Medicaid, PeachCare for Kids and all related waiver programs administered by the Department of Community Health's Medical Assistance Plans Division. R ]O'C Call us at (770) 458-8500 or contact us to learn more about obtaining personal homecare or skilled nursing care from one of our compassionate caregivers under the SOURCE waiver program. Georgia Pediatric Program (GAPP) @ S Pursuant to 42 C.F.R. ) - Updated 3/10/20. endobj Empowerline is here to help. (706) 792-7741 OR (800) 348-3503. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. - Posted 02/16/21, New C;y}r_a^mTN\; y~%[Bd\;iPC#_I to Medicaid members. Available services include personal support, home health services, specialized medical equipment and supplies, counseling, emergency response systems, and home modifications. Before sharing sensitive or personal information, make sure you're on an official state website. %%EOF website belongs to an official government organization in the United States. We can help connect you to privately and publicly funded resources from more than 26,000 community-based providers. Provides services to medically fragile children with multiple system diagnoses. Potential CCSP Provider . You may view the appropriate policies, and their attachments, by clicking on the links below: Both interested I/DD and BH providers are encouraged to review the applicable Provider Manuals for Community Providers, located on the DBHDD website:https://dbhdd.georgia.gov/community-provider-manuals. How do I know if I am in the right place? hO#+o"YI[:7 QO*$fL`m{s((P0(@L?:40QS`h)CVulT +C! For common provider enrollment questions and guides, access the FAQ for Providers page under the Provider Information menu. - Posted 2/21/19, Waiver To apply for services in the ICWP, contact Alliant Georgia Medical Care Foundation (GMCF) at 800-982-0411 or 888-669-7195. endobj The Mental Retardation Waiver Program (MRWP) assists people with disabilities who live in Georgia. 5 0 obj An official website of the State of Georgia. Click the following link for available dates and to register for the event: https://www.georgiacollaborative.com/providers/enrollment/. IeH")DW_OUOx.IwE&-M-,(YzPf*w{bv@oLNr%L^>?~cd{\o\t(Kh]sv2n{s4o6;kwa~j}w}Z"/)KA4-BKA Fm=" H I2 A4$Rm0, yRLo_g^:ULoBJ u84e)\.RP~)ffje__7_WOmp/g9s__k]0oN5kl]0 OT}gq^_i^^+* Local, state, and federal government websites often end in .gov. You can apply for an NPI on the NPPES website. sq(v~}m_xR3TM%n2> yxiST6T8 n%RA(G|rm5%S (=d8IS The following is a list of waiver programs in Georgia. Online Form. The Provider Enrollment Unit can be reached at the following: Fill out the Contact Us form. Secure .gov websites use HTTPSA To qualify, you must be eligible for Medicaid and: Be at least 65 years old (or, if younger than 65, meet certain disability requirements), Be impaired by physical limitations, Choose to receive services in your home or community instead of a nursing home, and Participate in only one waiver program at a time. Interested applicants must begin the process again at Phase 1, step 1 in a subsequent enrollment period at least one (1) year after the denial decision. Use this guide if any of the following apply: You're a health care provider who wants to bill Medicare for your services and also have the ability to order and certify. Provider agency must have the legal right to conduct business in the State of Georgia (i.e., current business license or other proof of legal authorization) b. Medicaid Waiver endobj An official website of the State of Georgia. Policies and Procedures for Medicaid/Peachcare for Kids Part I, Comprehensive Supports Waiver Program (COMP) & New Options Waiver Program (NOW) -, Comprehensive Supports Waiver Program (COMP)- Chapters 1300-3600 - Part III, New Options Waiver Program (NOW) Part III. Section 441.304, public notice is hereby given to the submission of a Medicaid 1915 (c) Elderly and Disabled (E&D) Waiver renewal. lv}WU:Zm~Z55*BT%ws]Qw4@ qs1t+ 183 0 obj <> endobj The NOW and COMP Waiver Programs provider services and support for people with intellectual or developmental disabilities. In addition to the waiver programs, Georgia offers other services through the regular Medicaid program designed to support people in their homes and communities. A guide to Medicaid Waiver Programs in Georgia is now available. % To sign up for a CCSP Provider Consult, please visit ourEventbrite pageto complete the registration (select the date you would like to attend in the drop-down box at the top). These manuals, listed below, will provide you with the definition of services and the associated standards. To apply for services contact a GAPP provider agency directly. How you know. Potential Provider Information . - Updated 10/20/17. Options Waiver Program (NOW) and Comprehensive Supports Waiver Program (COMP) PIQ ~R(P1 To apply for services in one of these programs, please refer to the Department of Behavioral Health and Developmental DisabilitiesServices (DBHDD). See if you qualify and apply for benefits. )aa:bdF:. What is the best number to call to get started? stream Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Independent Care Waiver Program (ICWP) ICWP offers services to a limited number of adult members with physical disabilities, including persons with traumatic brain injuries (TBI). click here To provide services in other counties, you can find the appropriate AAA ataging.georgia.gov. Ready to become a Medicare provider or supplier? about a provider in your area call: 404.657-7211 Division of Medical Assistance Plans under the Department of Community Health . All Rights Reserved. Official websites use .govA 2 0 obj hbbd``b`$0 H8ED|V@5W8d100R + A list of the applicable manuals is below. Both manuals can be found in the Medicaid web portal under Policy Manuals. We could be the answer you've . %PDF-1.5 For state Medicaid, a senior applicant is usually limited to either $841 / month or $1,133 / month in income and $2,000 in assets. Eligibility Requirements for being a CCSP Provider Any provider agency applying to be a CCSP Medicaid Provider must meet the following criteria: a. CCSP Provider Consults with the appropriate AAA are a required activity to complete the application process to become a CCSP provider. Georgia Technology Authority wants to hear from you to help make the internet more accessible to everyone. Local, state, and federal government websites often end in .gov. As an interested BH provider, you will find it helpful to review the Medicaid Provider Manual for Behavioral Health Services on the GAMMIS website at the following link: Community Behavioral Health Rehabilitation Services , Facebook page for Georgia Department of Behavioral Health and Developmental Disabilities, Twitter page for Georgia Department of Behavioral Health and Developmental Disabilities, Linkedin page for Georgia Department of Behavioral Health and Developmental Disabilities, Addictive Diseases Training Announcements, Cultural and Linguistic Competence Training Series: Diversity Works, Developmental Disabilities Training Announcements, Enterprise Compliance & Background Investigations FAQs. >{u9xqH E O"'@I:w PPx) &~}o)`p &.=a0qL U" P$ State of Georgia government websites and email systems use "georgia.gov" or "ga.gov" at the end of the address. Local, state, and federal government websites often end in .gov. Providers offering Personal Support Services and Skilled Nursing must have their license from DCH for at least nine (9) months as of the month of application to become a CCSP provider.