Children's Home and Community Based Services (HCBS) Waiver Provider Information
Policy
- HCBS Service Definition and Necessity Criteria Policy #CW0020 - May 16, 2025
- Children's Waiver Fee-for-Services Authorization Policy #CW0019 - December 31. 2024
- Provider Service Delivery Documentation Policy for Children's HCBS #CW0017 - August 20, 2024
- Conflict-Free Case Management Policy #HH0012 - Updated: November 2022
- HCBS Provider Designation: Non-licensed/Designated/Certified Provider #CW0014 - Effective April 11, 2022, Updated October 11, 2022
- Palliative Care: Counseling and Support Services and Health Home Care Management Policy #CW0015 (PDF) - December 2021
- Children's HCBS Provider Designation and Re-designation Procedure #CW0013 (PDF) - Revised July 2021
- Participant's Rights and Choice Policy #CW0009 (PDF) - Effective April 1, 2021
- Complaint and Grievance Policy for HCBS Providers #CW0008 (PDF) - Effective April 1, 2021, Updated November 2022
- Children's HCBS Waiver Disenrollment Policy #CW0006 (PDF) - Effective April 1, 2021
- HCBS Provider Reportable Incidents Policies and Procedures #CW0004 (PDF) - Effective April 1, 2021, Updated November 2022
- Children's Waiver HCBS Policies (PDF) - February 2021
- HCBS Provider De-Designation Procedure #CW0003 (PDF) - September 2020
- HCBS & CFTSS Timely Claim Filing Guidance (PDF) - June 2020
- Background Check Requirements for HCBS Providers #CW0001 (PDF) - Effective April 1, 2019
Guidance
- Children's Waiver Home and Community Based Service (HCBS) Contracting Requirements for Medicaid Managed Care Plans (MMCPs) - February 4, 2025
- Children's Waiver Mandated Reporter Training Requirements - December 23, 2024
- REMINDER: Children's Waiver Home and Community Based Service (HCBS) Designated Provider Site Requirements (PDF) - December 5, 2024
- Medicaid Provider Enrollment for Individual Practitioners and Designated Agencies - March 8, 2019
- Children's Waiver HCBS Staffing Allowances Clarification - October 19, 2023
- Children's HCBS Medicaid Managed Care Plan Transfer Continuity of Care Requirements - September 5, 2023
- Utilization Management and Other Requirements for 1915(c) Children's Waiver Services (PDF) - Updated May 8, 2023
- Changes to Respite Telehealth Services Under the 1915(c) Children's Waiver Home and Community Based Services (HCBS) (PDF) - December 13, 2022
- Designated HCBS Provider Attestation (PDF) - Updated November 2022
- Use of Foreign Education Documents to Verify HCBS Staff Qualification Requirements (PDF) - July 28, 2022
- Children's HCBS Billing and Claiming Required Processes (PDF) - April 4, 2022 (PDF)
- Continuity of Care for CFTSS and HCBS (PDF) - Updated November 2020
- HCBS Provider Directive to Continue Services to Participant and Seek DOH Assistance (PDF) - October 2020
- HCBS Versus State Plan Services Delivered During School/Day Time - Updated May 2023
- Children's Medicaid Spend-down Coverage Guidance (PDF) - May 2020
- Effective Changes to the Children's Waiver of HCBS and Children and Family Treatment and Support Services (CFTSS) - April 2020
- Process for Renewing and Establishing Medicaid for Children's Waiver Participants (PDF) - March 2020
- Guidance for Providers Regarding Student Interns and Limited Permits for CFTSS and HCBS Required to be Provided by a Licensed Practitioner (PDF) - June 2019
Webinars and Provider Meetings
State Discussion with Children's Waiver HCBS Providers
2026
- Recent Announcements, IRAMS Updates & Reminders, 2026 Waiver Amendment, HCBS Care Coordination, 1915(c) Waiver Renewal, HCBS Authorization Fair Hearing, Future Meetings & Contact Information - June 24, 2026
- Recent Announcements, IRAMS Reminders & Updates, HCBS Authorization Reminders, Upcoming Waiver Amendment, Future Meetings (PDF) - February 25, 2026
- 2026 HCBS Provider/State Discussions Schedule
2025
- IRAMS Requirement Reminders, Updates & Survey, Service Definition and Necessity Criteria Policy Feedback, HCBS Provider Case Reviews, Proposed 1915(c) Amendment, Future Meetings (PDF) - October 22, 2025
- Policy, Guidance, & Webinar Updates, IRAMS and HCBS Authorization Reminders, General Reminders for HCBS Providers, HCBS Provider Case Reviews, Future Meetings & Contact Information (PDF) - August 20, 2025
- DOH Billing Outreach, County and Site Designation, HCBS Provider Role and Responsibilities, HCBS Eligibility and Enrollment, IRAMS and HCBS Authorization Reminders (PDF) - April 23, 2025
- Provider Designation, Provider Contact Info, HCBS Eligibility Determination Expiration, Providers Without Claims, CHPlus HCBS Coverage, IRAMS Reminders, HCBS Authorizations, Mandated Reporter Requirements (PDF) - March 19, 2025
- 2025 HCBS Provider/State Discussions Schedule (PDF)
2024
- Referral & Authorization Portal, FFS Authorization UPDATE, Recap from HCBS Stakeholder Collaborative Meeting, CHPlus HCBS Benefit Enhancement, Initial Service Period, Monthly HCBS Provider Meetings 2025, Next Meeting & Contact Information (PDF) - December 18, 2024
- eFMAP Provider Survey, HCBS Site Designation, Referral & Authorization Portal, FFS Authorizations, HCBS Stakeholder Collaborative Meeting, Monthly HCBS Provider Meetings in 2025, Next Meeting & Contact Information (PDF) - November 20, 2024
- HCBS COLA Rate Increase, Capitation, Change in K-Codes for Eligibility & Enrollment, Designation and Documentation Reminders, eFMAP Provider Survey, CFR, FFS Authorization Policy, & Referral & Authorization Portal Stakeholder Collaborative Meeting, Future Meetings & Contact Information (PDF) - October 2024
- Staff Compliance, Referral and Authorization Portal, New system Features, Short-Form Connection Process & Reminders, User Guide Updates, Survey Feedback, Respite Group of Two & Rural Rates, Documentation Policy (PDF) - August 2024
- Documentation Policy Update, 4% COLA Increase, Non-Risk Payments Moving to Capitation, Summer Programming, Palliative Care, IRAMS/ Submitting Staff Qualification Information, Electronic Referral/Authorization Portal (PDF) - June 2024
- Eligibility & Enrollment, PHE Unwind, FIPS, Authorization & Referral Form, Discharge & Disenrollment, Final Rule, Waiver Amendment/Approval (PDF) - February 2024
- Respite Billing Reminders, HCBS Provider Case Reviews, Reminder of F/S/D Determinations, HCBS Provider Designation and how Services are provided - January 2024
- 2024 Monthly HCBS Provider/State Discussions Schedule
2023
- eFMAP, Waiver Amendment, Updated Claims Submission Process, Electronic Referral, Relative Definition, HCBS Eligibility Clarification, Provider Case Review (PDF) - November 2023
- eFMAP, Billing Updates, Continuity of Care Requirements, Electronic Referral and Authorization Forms, CFASS Staffing Changes and Authorization (PDF) - September 20, 2023
- Staff Compliance Tracker, Updated Authorization Form, Referral Portal, Waiver Amendment, Annual Case Reviews (PDF) - July 2023 (PDF)
- Documentation Policy, SMART Goals, Parent Info Sheets, HCBS During the School Day, UM Update, IRAMS, Referral Portal (PDF) - May 2023 (PDF)
- Documentation Policy, Regional Meetings, eFMAP Updates - April 2023 (PDF)
- WY2021-2022 Case Review Combined Meeting - January 2023
2022
- HCBS Case record Review, eFMAP Updates, Electronic Referral Form - December 2022 (PDF)
- eFMAP Updates, HCBS Provider Attestation Reminder, POC Workflow, Medical Necessity (PDF) - November 2022
- Case Review &Next Steps, eFMAP Updates, HCBS Provider Attestation, HCBS F/S/D (PDF) - October 2022
- Amendment Update, eFMAP Updates, HCBS Manual, Capacity Tracker Updates, HCBS referral process (PDF) - September 2022
- Waiver Renewal, Amendment Update, eFMAP updates, HCBS Annual Audit and Case Review (PDF) - August 2022
- Waiver Renewal and Amendment, eFMAP Updates, HCBS staff Qualification and Case review, Authorization Reminder (PDF) - July 2022
- Case Review Follow-up, eFMAP Updates, Building Capacity, Palliative Care Services and Medical Respite (PDF) - June 2022
- Case reviews, Capacity Tracker Survey Reminder and Feedback, eFMAP Updates (PDF) - May 2022
- Year 2021-2022 HCBS Provider Review Information Session (PDF) (Process Overview-timeline, communication, sampling) - May 2022 (PDF)
- Waiver Renewal, Temporary Extension, MMCP Pass throughs, Bereavement, HCBS Billing and Claiming (PDF) - April 2022
- eFMAP Updates, Capacity Tracker updates & Preliminary Data, Final Rule Updates, HCBS Designation (PDF) - March 2022
- eFMAP, Waiver Renewal, Children's Service Capacity Tracker, Case Review Waiver Year 21-22 (PDF) - February 2022
2021
- Waiver Amendment, Provider Designation Attestation, eFMAP, Waiver Renewal, Capacity Tracker (PDF) - November 2021
- eFMAP, Waiver Renewal, Pending Waiver Amendment, Provider Designation Attestation (PDF) - October 2021 (PDF)
- HCBS Provider Attestation (PDF) - November 2021
- Children's HCBS Provider Designation, HCBS Case Reviews & Training Survey, Children's Waiver Updates, IRAMS Q&A (PDF) - June 2021
- IRAMS, Final Rule Reminder, Follow-up: HCBS Delivery Education (PDF) - April 2021
- Special Needs of Target Populations, Tracking HCBS Capacity, IRAMS (PDF) - March 2021
- Annual HCBS Case Reviews, Follow-Up: proposal to combine CFSS with CSATS (PDF) - February 2021
- Final Rule, Discussion: proposal to combine CFSS with CSATS (PDF) - January 2021
2020
Additional Webinars
- Provider Service Delivery Documentation Policy for Children's HCBS (PDF) | (Recording) (YouTube) - July 17, 2024
- Palliative Care Bereavement Counseling and Bereavement Coordination by HH | Recording (YouTube) - December 2021 (PDF)
- Plan of Care & Person Centered Planning Requirements (PDF) | Recording (YouTube) - April 2021
- IRAMS User Introduction for HCBS Providers and C-YES (PDF) | Recording (YouTube) - March 2021
- Children's Waiver Reporting for Critical Incident and Complaints & Grievances (PDF) | Recording (YouTube) - March 2021
- Children's Waiver Enrollment and Disenrollment Webinar (PDF) | Recording (YouTube) - March 2021
- Participant Rights and Choice Webinar (PDF) | Recording (YouTube) - February 2021
- Medicaid and the Children's Waiver Webinar (PDF) | Recording (YouTube) - January 2021
- Understanding Medicaid Webinar (PDF) | Recording (YouTube) - January 2021
Resources
- Children's HCBS Brochure (PDF) - August 19, 2022
- Children's System Definitions Tip Sheet (PDF) - November 2020
HCBS Setting Rule
- HCBS Final Rule Compliance Policy #CW0016 - December 3, 2020, Updated October 17, 2022
- Children's HCBS Providers Final Rule Documentation Worksheet (XLSX) - Updated May 2024
- HCBS Final Rule Background and Compliance Review Overview for the Children's Waiver (PDF) - (Recording)
- Home & Community-Based Services (HCBS) Final Rule
- Children's Waiver HCBS Provider Final Rule Setting Self-Assessment Communication (PDF) - December 3, 2020
- Children's Waiver HCBS Final Rule Survey (External link)
- HCBS Final Rule Statewide Transition Plan (PDF) - Updated in response to CMS comment received initial approval November 2018 (PDF)
- CMS Feedback for Final Approval Letter - Received May 2019
- Initial Approval Letter - Received November 2018
- HCBS Final Rule Statewide Transition Plan (PDF) - Updated May 2018 in response to CMS comment
- HCBS Final Rule Statewide Transition Plan (PDF) - Updated September 2017
- HCBS Final Rule Statewide Transition Plan (PDF) - Updated January 2017
- Systemic Compliance Charts for Waivers that were Subsumed into the Combined 1915(c) Children's Waiver - please note that these charts contain original systemic review raw data
Electronic Visit Verification (EVV)
- Children's Waiver Requirements for Electronic Visit Verification (EVV)
- Children's Waiver Electronic Visitor Verification (EVV) Annual DECLARATION Form (PDF)
- Announcing Electronic Visit Verification Requirements (PDF) - October 20, 2020
- NY Medicaid Electronic Visit Verification Program (EVV) Resource Library
HCBS Case Reviews
- OMIG Self-Disclosure Overview for Medicaid Managed Care Organizations (PDF) | Recording (YouTube) - August 26, 2025
- OMIG Self-Disclosure Overview for HCBS Providers and Health Homes (PDF) | Recording (YouTube) - August 13, 2025
- Children's Waiver HCBS Provider Review CAP Technical Assistance Guide (PDF) - July 2025
- HCBS Provider Review Information Session (PDF) | Recording (YouTube) - September 18, 2024
