how to become a medicaid waiver provider in georgia
Georgia is enrolling board certified behavioral analysts to provide ABS. The latest articles and announcements on Amerigroup policies, processes, updates to clinical guidelines, claims filings, state and federal regulatory changes, and more: Medicaid updates. ( (xC]`)q6> State of Georgia government websites and email systems use "georgia.gov" or "ga.gov" at the end of the address. 5 0 obj - Updated 3/10/20. endstream endobj 188 0 obj <>stream Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Local, state, and federal government websites often end in .gov. See, for example, Adena Regional Medical Center v. (click to hide)Alert Message posted 3/27/2020, Skip to Provider Enrollment Subsystem Menu. 3 . 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. The Provider Enrollment Unit can be reached at the following: Fill out the Contact Us form. 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. For more information on how to apply, visit, Georgias Department of Community Health website, ARC has no active role in processing or approving applications to become a Community Care Services Program (CCSP) provider. Community Care Services Program (CCSP ) and Service Options Using Resources in a Community Environment (SOURCE ) - Updated 3/10/20 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. Once the LOI has been approved, you will receive an invitation to apply. COMP You may view the appropriate policies, Recruitment and Application to Become a Provider of Developmental Disability Services, 02-701, Recruitment and Application to become a Provider of Behavioral Health Services, 01-111, Financial and Reporting Requirements for Community Providers, 21-101. are encouraged to review the applicable Provider Manuals for Community Providers, located on the DBHDD website: https://dbhdd.georgia.gov/community-provider-manuals, Provider Manual for Community Behavioral Health Providers, Provider Manual for Community Developmental Disability Providers. - Posted 02/16/21, New 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). PIQ ~R(P1 FAQ for behavioral health providers regarding prior authorization for individual and family therapy codes bathing, dressing, meals, and housekeeping), home health services (nursing, home health aide, and occupational, physical and speech therapy). Local, state, and federal government websites often end in .gov. Links to the public notices and draft waiver applications are listed below. Aging and Independence Services: a Q&A with Becky Kurtz, Metro Atlanta/DeKalb County Digital Connectivity Listening Session, Personal Support Serviceassistance with bathing, light housekeeping, laundry, shopping, meal preparation, and respite (caregiver relief), Alternative Living Servicesmeals, personal care, and supervision in an approved personal care home. "xG^FZh;O8\iy^0AFeE#~-aB _mh K)Z3r >oT->+ L}$\ZSypts [}s[pYI._.jJ&*40)|[cPU|9V&=pC~7kj~xcR1>5>)`lB3{jgj|zu_3\O5c\j;2Ft(|5UdC /w.s}7U1242LV.2eH2*M[w+uFA:x7FX8ztjf#;R_kUMFUu2gKa7{=/9v@a*Uj3^ T 9srz>n.QI>dY294? HVKo8WH(K@Q E]n=j/8jCdYi)f7B (706) 792-7741 OR (800) 348-3503. The 12 ADRC offices are identified by counties served. Email Us. Become a Medicaid provider. Local, state, and federal government websites often end in .gov. Before sharing sensitive or personal information, make sure youre on an official state website. Found in the Elderly & Disabled Waiver Program, the CCSP and SOURCE Programs serve frail elderly and disabled Georgians otherwise eligible under a nursing facility level of care through the provision of case management for service coordination, adult daycare, alternative living services, personal care, home-delivered meals, and respite care for family caregivers. To provide services in other counties, you can find the appropriate AAA ataging.georgia.gov. endobj This program is available for eligible Medicaid members who are severely physically disabled and between the ages of 21 and 64 when they apply. For instructions and forms related to provider enrollment, access the Enrollment Forms page under the Provider Enrollment menu. Offers services for individuals with intellectual and/or developmental disabilities who require an intermediate care facility. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. ! Vaf@=&wxh$R g|gV]7%ABkktO |jz*)%sjp>Zx/MWE&SDU`v 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). 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 . What is the best number to call to get started? 215 0 obj <>stream ; You don't want to bill Medicare for your services, but you do want enroll in Medicare solely to order and certify. . Home and Community Services Guide Available, American Rescue Plan Act Initial Spending Plan. For more information on how to apply, visit Georgia's Department of Community Health website. 0 '<0c BAcaXC]va0y'A"_%:bIc(:'xO%.S I8J4a]H K c*G?^50&aInA /cEe`(00VoXUf,ncUe er7-c^QR(y u_P6l@ul %Z=*JFx])(u=h7VY``KN`"F43FT bq0I\&{U\yCv^_x]uvEaxA&ems- EgV+$10l.R!,x?U?EVusxp9VsaVrn{jq5bSTtf[#uvRet N|CNxRo~zZ,w9_/{Xoq zqow+^_ujd(bQPwWn7}Azhu[T_ We're here to help. Medicaid Waiver Population Served/ Eligibility Financial Eligibility Services Provided Wait List Cost Share Case Manager Intake . Search the NPI Registry. Initial Spending Plan Projection and Narrative for the ARPA10% point increase in FMAP for HCBS. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. For those services that require a state license, your agency must already be licensed by the DCH Division of Healthcare Facility Regulation in order to attend a CCSP Provider Consult. Potential Provider Information . Not sure if you have an NPI? +V:NvRXA1/Nari4V You must register and attend a New Provider Enrollment Forum, presented by the Georgia Collaborative ASO. Persons served through the CCSP Program must be eligible for Medicaid and meet the following requirements: Have cognitive and or physical impairments/limitations which make it difficult to perform normal daily living activities and live independently Georgia Technology Authority wants to hear from you to help make the internet more accessible to everyone. The Community Care Services Program (CCSP) is a Medicaid-funded program that serves individuals with limited income and resources who have the kinds of needs that would qualify them for nursing home care. 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. ; You wish to provide services to beneficiaries but do not want to bill Medicare for your services. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. 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. 2023 Atlanta Regional Commission. Your MAC can help you navigate the enrollment process and answer questions about your application. PECOS has video and print tutorials and will walk you through your enrollment to ensure your information is accurate. CCSP Provider Consults with the appropriate AAA are a required activity to complete the application process to become a CCSP provider. 7 0 obj 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. 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. To be eligible for Medicare, a . 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. Serves frail, elderly, and disabled Georgians by providing coordinated services in their home or community. sq(v~}m_xR3TM%n2> yxiST6T8 n%RA(G|rm5%S (=d8IS This email will contain information regarding New Provider Orientation. ) and Ready to become a Medicare provider or supplier? endobj You can also contact GMCF at www.gmcf.org . Our research finds the funding amounts for PERS services ranged from $25 - $75 / month. You can also check in with your MAC regarding your enrollment status. A complete list of Medicaid . Pursuant to 42 C.F.R. Its important to keep your enrollment information up to date. I. The Georgia Department of Community Health (DCH) values all physician and health care provider contributions to the health and well-being of all Georgians. Medicare is a federal program. endobj @ S Eligibility Requirements for being a CCSP Provider Any provider agency applying to be a CCSP Medicaid Provider must meet the following criteria: a. Medicaid waiver programs providerecipients certain services not normally covered by Medicaid. stream endobj click Secure .gov websites use HTTPSA 4 0 obj Providers can also enroll to become a participating provider using the Enrollment Wizard . For more information on how to apply, visitGeorgias Department of Community Health website. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. 3 0 obj 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. h]|;nO73xiKD9 &t&|4>F3 Hd""W;S|i~00T|Attq{pcE^kTuU"c`rwLfT|HLn q. 08&@}68O`0YuL &DR V-cSDm c1YeSX@rT:dPaLup9CU2C' ^U:d! J0xhcni).P~EJRt l ^E`>XBI!_~ endobj Apply for Medicaid Medicaid has several programs that can help you or your family. p?.e^Tv+2,[P3-Nj` @Fy https:// All Rights Reserved. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. You can also contact GMCF at www.gmcf.org. ]O'C Before sharing sensitive or personal information, make sure you're on an official state website. CCSP gives these individuals access to services that are essential for daily life so that they may remain in their homes and communities. I. All Contacts. zi>n[q@. access the NOW Draft Application click here. 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 An official website of the State of Georgia. Local, state, and federal government websites often end in .gov. xUo1~??&q~TUZCML}@{@> +]aK?SYIJ',,{a=x:jTZ^*UhQ,e1 ,cz] x8!AUfG94a`)E,&Y %PDF-1.5 % 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 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). Amendment Application for Georgias Elderly & Disabled Waiver Program TcxcA[,0#WjhQGG8+yBXlo?ra7"a6 \u T\\/7el?~=>SA`vL"o[Fo FGr[syhGuU,em]vW3 km$^\lZT2OJH# State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. PRvH}+m`\=G7&%/^(Z0XxS{'h2LA)eVPac2*GQrFi0:pNQl+#sWD9; ZzkqkYf|; _%WmW S&~O1: .mrQbO`e1$+-|b&s5A&HpTNG>sYz (V] l{T 3CYNK^oE`!|nyM\,"7FK! lock Applications are accepted by DCH in March and September of each year. <> 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. Heres how you know. However, misconceptions Read More, As Metro Atlantas Area Agency on Aging, ARC Serves Needs of Older Residents As the planning agency for the Atlanta region, the Atlanta Regional Commission Read More. HVn0+ T(e(8AF-~,%YvA$w3$, 'Yghj4Ska8}"]|&3Qb9W;RN5 5[1f}Mt2e63Q6l2IQXPe|I7BrQ.F48+'9]gs; A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. y(v3Dlq+d9f{yv+M1NZB)"8Sun)8KB"$LG4a6 UD(z qAZDF40n> ,r(oM!q_ sfBzQw;EM:k$j"U'-Z`V*|[qt!o]PC{53={e*H hf;skWSJRMpuEGsLs&5m`"36$t1]MUL.5FZcAjdf(Z]g=-V6F0FAh%hdf^~|T#r }*UAXZ+s_ 9Pp!~0 >stream (u0o"q Bt$ Il&0t}V%YXe-'37# ) ) - Updated 3/10/20. 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. Local, state, and federal government websites often end in .gov. How do I know if I am in the right place? 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. Each state has its own waivers and each waiver, its own policy. Provides services to medically fragile children with multiple system diagnoses. )aa:bdF:. For instructions and forms related to provider enrollment, access the Enrollment Forms page under the Provider Enrollment menu. Options Waiver Program (NOW) and Comprehensive Supports Waiver Program (COMP) %PDF-1.6 % An official website of the United States government The Division of Medicaid, in the Office of the Governor, will submit this proposed waiver to the Centers for Medicare and Medicaid Services (CMS) effective July 1, 2023, contingent upon . endstream endobj 184 0 obj <>/Metadata 13 0 R/Outlines 36 0 R/PageLayout/OneColumn/Pages 181 0 R/StructTreeRoot 43 0 R/Type/Catalog>> endobj 185 0 obj <>/Font<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 186 0 obj <>stream We're here to help. Call the local number (770) 325-9600 Call the toll-free number (800) 766-4456 See if you qualify and apply for benefits. 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. 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. 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). NPIs are issued through the National Plan & Provider Enumeration System (NPPES). For details about this waiver renewal, For common provider enrollment questions and guides, access the FAQ for Providers page under the Provider Information menu. How you know. %PDF-1.5 A list of the applicable manuals is below. BIL> +x! Another option for frail, elderly, and disabled Georgians that provides coordinated services in their home or community. Click the following link for available dates and to register for the event: https://www.georgiacollaborative.com/providers/enrollment/. R Applications are accepted by DCH in March and September of each year. {UQ2R`%c`VT:dpCU2T_(Fd$+*JFzd JFbJFfdJF:dC C0\ U3:dw!#hYD8C"L "DFV%2*UG`p=FQ1jf*DW!ru^=W1^Ipl7 .(6D!,M|YK` If youre enrolling a, Youre a health care provider who wants to bill Medicare for your services and, You dont want to bill Medicare for your services, but you do want enroll in Medicare, You wish to provide services to beneficiaries but do not want to bill Medicare for your services. For questions not answered in this Guide, please contact HPES at 1-800-766-4456. www.mmis.georgia.gov Updated 11/28/2011 You can apply for an NPI on the NPPES website. Eligibility for ICWP is based on either a nursing facility or hospital level of care for adults with severe physical disabilities or traumatic brain injury (TBI). How you know. A guide to Medicaid Waiver Programs in Georgia is now available. Official websites use .govA The Program Specialist may occasionally send Banner messages through web portal for important notifications. Waiver programs help people who are elderly or have disabilities and need help to live in their home or community instead of an institution such as a nursing home or ICF-MR. On July 14, 2022, the Centers for Medicare and Medicaid Services notified DCH of its approval for 1915(c) Comprehensive Supports Waiver renewal for individuals with intellectual and/or developmental disabilities. hb`````f`f`0 |@1 h``ZPxjGd`8H 1/H92i? endstream endobj 187 0 obj <>stream Complete the online PECOS application. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. N.4q]KXc''}iR@:`9~d`'a^[JB(ZIG`+0 t}qS`^:},?6S)^W:W>ezjWI]e {Y}Z0p OGUH F`Rd#0@PvRzxDSL] %M1e2^3ba vEZes6bw>/4"|/8:K[5,K\4tvK$&K~ .g\7C%Uw=}gS=t/*/fr. Send a Message. obtain a clear understanding of this Medicaid Waiver. Georgia Pediatric Program (GAPP) The Provider Enrollment Unit enrolls qualified providers to receive Medicaid reimbursement for services rendered Each program offers several "core" services: Additional services are available under each program. Primary: (404) 657-5468. Georgia's Medicaid Waivers & Programs . - Updated 3/10/20. These manuals, listed below, will provide you with the definition of services and the associated standards. % Georgia Department of Community Health's (DCH) Office of Inspector General (OIG) is responsible for Medicaid Provider Enrollment. Department of Human Services, Division of Family and Children Services, Georgia Department of Behavioral Health and Developmental Disabilities. Potential Provider Information . Medicaid waiver programs provide recipients certain services not normally covered by Medicaid. Thank you for your interest in becoming a provider for DBHDD! Click here for help and information about bookmarks. This guide will help you enroll in three steps. We could be the answer you've . A guide to Medicaid Waiver Programs in Georgia is now available. endobj (You can still use this guide if you dispense Part B drugs used with DMEPOS, such as inhalation drugs. The CCSP Provider Consult is not a general information session. Some of those are described in this guide and include At Health Force of Georgia, we understand the challenges you face taking care of a loved one with needs. ]4@P-Ek/lRM3sGIU8U4O)Llo[Onnq#VqltfR_Sy*(^4C#fK.[?;Y,DtK/4:P^+hcJy{ld" Provider News. [L(1+R`X#o$(WN:roBGu8k=YCx:F1#(X96nD|/:j3ZagB}JLv] )PE 8_{3YWx^9nDz)v PGRU@2' :O?z)l&.x/Jd^dHp#+21qmh;wF2-8?ktrNw2n+VkmdF;NqRTJ@pd5o3i%=[/0"';y,>K T{w[J}L*VvBMB/4QV[q h Share sensitive information only on official, secure websites. For state Medicaid, a senior applicant is usually limited to either $841 / month or $1,133 / month in income and $2,000 in assets. - Updated 10/20/17. Service To qualify for a waiver program, you can have higher income and resources than permitted in the regular Medicaid program. Try not to admit members until you have an understanding of ICWP The ICWP Policy is updated quarterly. GAPP nursing agencies can be found in Appendix U of the GAPP provider manual on the GAMMIS website. If the DCH application is approved, DBHDD will notify you via an email communication of your approval as either a BH or I/DD Provider. >{u9xqH E O"'@I:w PPx) &~}o)`p &.=a0qL U" P$ Services are provided in their homes and communities and includenursing services to address the need for skilled professional services and personal care support services that assist with activities of daily living. - Posted 2/21/19, Waiver 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. Gather What You'll Need Many people qualify to receive Medicaid, but first you have to apply. Both manuals can be found in the Medicaid web portal under Policy Manuals. (In this case, you would need to, You want to enroll as a supplier who does not dispense or furnish durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). endstream endobj startxref <> Potential CCSP Provider . To apply for services in the ICWP, contact Alliant Georgia Medical Care Foundation (GMCF) at 800-982-0411 or 888-669-7195. or An official website of the State of Georgia. 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. To apply for services in either program, contact the Georgia Aging and Disability Resource Connections(ADRC). hmO6?}`w h! 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. Independent the Georgia Elderly and Disabled 1915c Medicaid Waiver and provides Home-and Community-Based Services to frail elderly and physically disabled people . ;e_\7b%A6q%Phzp'|gToI1]si NpQ,*uqx:JjvL}AjU+qi,. access the EDWP Public Notice click here. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Enroll using PECOS,i the online Medicare enrollment system. The waivers allow healthcare professionals to provide care in a person's home or community instead of a long-term care facility. Per DCH policy you must wait one (1) year before submitting another application. *x(Pi lock 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. 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. We can help connect you to privately and publicly funded resources from more than 26,000 community-based providers. \q~4za\c5f %%EOF U%:I("r-*gQF+'W8>wT, HjF Eligibility Requirements for being a CCSP Provider Any provider agency applying to be a CCSP Medicaid Provider must meet the following criteria: a. Available services include personal support, home health services, specialized medical equipment and supplies, counseling, emergency response systems, and home modifications. 2 0 obj A list of the applicable manuals is below. YouTube page for Georgia Medicaid; How can we help? 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. The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) provides day-to-day operations in these programs through six regional field offices. Amendment Application for Comprehensive Supports Waiver Program Waiver HP Enterprise Services (HPES) is the Fiscal Agent for Georgia Medicaid. An official website of the State of Georgia. lv}WU:Zm~Z55*BT%ws]Qw4@ qs1t+ The NOW and COMP Waiver Programs provider services and support for people with intellectual or developmental disabilities. 197 0 obj <>/Filter/FlateDecode/ID[<234E316E3F783646B907FABD30F2C407>]/Index[183 33]/Info 182 0 R/Length 77/Prev 46133/Root 184 0 R/Size 216/Type/XRef/W[1 2 1]>>stream