Children's Home and Community Based Services (HCBS) Waiver Provider Information

  • 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 - 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
  • Medicaid Provider Enrollment for Individual Practitioners and Designated Agencies - (Web) - (PDF) - March 8, 2019
  • Children's Waiver HCBS Staffing Allowances Clarification - (Web) - (PDF) - October 19, 2023
  • Children's HCBS Medicaid Managed Care Plan Transfer Continuity of Care Requirements - (Web) - (PDF) - 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 - (Web) - (PDF) - 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) - (Web) - (PDF) - April 2020
  • Process for Renewing and Establishing Medicaid for Children's Waiver Participants - (PDF) - March 2020
  • Requirements for Service Providers Delivering CFTSS and Children's HCBS (Web) - (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

Monthly State Discussion with Children's Waiver HCBS Providers

  • 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 - (Web) - January 2024
  • 2024 Monthly HCBS Provider/State Discussions Schedule - (Web)

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 - (Web) | (PDF) | Recording (YouTube) - December 2021 (PDF)
  • Plan of Care & Person Centered Planning Requirements - (PDF) | Recording (YouTube) - April 2021
  • Incident Reporting and Management System (IRAMS) User Introduction for Health Homes and Care Management Agencies - PDF | Recording (YouTube) - March 2021
  • Incident Reporting and Management System (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
  • HCBS Provider Review Information Session - (PDF) - (Recording) - September 18, 2024