how to become a medicaid waiver provider in georgia how to become a medicaid waiver provider in georgia

R This guide will help you enroll in three steps. Click here for help and information about bookmarks. - Updated 3/10/20. }~+U#Y7*vv5/k*3SX7s>_M 431@*5V)*MNd xc|DX?2l*;nB6}o94d}p7a{31}wBbyJ8-T H+v Medicaid Waiver Population Served/ Eligibility Financial Eligibility Services Provided Wait List Cost Share Case Manager Intake . This program is available for eligible Medicaid members who are severely physically disabled and between the ages of 21 and 64 when they apply. . 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_ Each program offers several "core" services: Additional services are available under each program. GAPP nursing agencies can be found in Appendix U of the GAPP provider manual on the GAMMIS website. 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. 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. For instructions and forms related to provider enrollment, access the Enrollment Forms page under the Provider Enrollment menu. )aa:bdF:. 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. See, for example, Adena Regional Medical Center v. lv}WU:Zm~Z55*BT%ws]Qw4@ qs1t+ The waivers allow healthcare professionals to provide care in a person's home or community instead of a long-term care facility. \q~4za\c5f endobj 5 CX A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. 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. access the NOW Draft Application click here. The Georgia Department of Community Health (DCH) values all physician and health care provider contributions to the health and well-being of all Georgians. Search the NPI Registry. Section 1135 Waiver Flexibilities Coronavirus Disease 2019 (COVID-19) Unwinding and Returning to Regular Operations after COVID-19 Medicaid and CHIP Resources CMCS Medicaid and CHIP All State Calls State Waiver and Amendment Approvals Tools and Checklists for States Other Agency Guidance Press Releases SPA and 1915 Waiver Processing 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. Each state has its own waivers and each waiver, its own policy. An official website of the State of Georgia. A complete list of Medicaid . i If youre unable to apply online using PECOS, you can use a paper application form. J0xhcni).P~EJRt l ^E`>XBI!_~ NPIs are issued through the National Plan & Provider Enumeration System (NPPES). 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 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. All Rights Reserved. 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. 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 Providers can also enroll to become a participating provider using the Enrollment Wizard . +V:NvRXA1/Nari4V ! Vaf@=&wxh$R g|gV]7%ABkktO |jz*)%sjp>Zx/MWE&SDU`v How you know. 451 0 obj <>stream CCSP Provider Consults with the appropriate AAA are a required activity to complete the application process to become a CCSP provider. 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. Medicaid Waiver The latest articles and announcements on Amerigroup policies, processes, updates to clinical guidelines, claims filings, state and federal regulatory changes, and more: Medicaid updates. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. 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 . Your MAC can help you navigate the enrollment process and answer questions about your application. Enroll using PECOS,i the online Medicare enrollment system. 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/. zi>n[q@. Care Services Program (CCSP HCBS Guide (4.17 MB) 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. COMP 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. PECOS has video and print tutorials and will walk you through your enrollment to ensure your information is accurate. Medicaid provides access to free and low-cost medical care in Georgia. %%EOF - Updated 10/20/17. 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. 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. - Updated 3/10/20. 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. Options Using Resources in a Community Environment (SOURCE Learn more Renew Medicaid Benefits 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$&K~ .g\7C%Uw=}gS=t/*/fr. %PDF-1.6 % Georgia Department of Community Health's (DCH) Office of Inspector General (OIG) is responsible for Medicaid Provider Enrollment. You may view the appropriate policies, and their attachments, by clicking on the links below: Both interested I/DD and BH providers are encouraged to review the applicable Provider Manuals for Community Providers, located on the DBHDD website:https://dbhdd.georgia.gov/community-provider-manuals. An official website of the United States government In response to the Centers for Medicare & Medicaid Services (CMS) approval of Medicaid Section 1135 Waivers for COVID-19, the State of Georgia Department of Community Health will expedite new enrollment applications until further notice. Medicaid waiver programs providerecipients certain services not normally covered by Medicaid. HVn8}W#YDH At Health Force of Georgia, we understand the challenges you face taking care of a loved one with needs. ]4@P-Ek/lRM3sGIU8U4O)Llo[Onnq#VqltfR_Sy*(^4C#fK.[?;Y,DtK/4:P^+hcJy{ld" Provider agency must have the legal right to conduct business in the State of Georgia (i.e., current business license or other proof of legal authorization) b. Policies and Procedures for Medicaid/Peachcare for Kids Part I, Comprehensive Supports Waiver Program (COMP) & New Options Waiver Program (NOW) -, Comprehensive Supports Waiver Program (COMP)- Chapters 1300-3600 - Part III, New Options Waiver Program (NOW) Part III. Home and Community Services Guide Available, American Rescue Plan Act Initial Spending Plan. An official website of the State of Georgia. Eligibility Requirements for being a CCSP Provider Any provider agency applying to be a CCSP Medicaid Provider must meet the following criteria: a. click y(v3Dlq+d9f{yv+M1NZB)"8Sun)8KB"$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 Georgia Technology Authority wants to hear from you to help make the internet more accessible to everyone. 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. 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. <> Amendment Application for Comprehensive Supports Waiver Program 5 0 obj {UQ2R`%c`VT:dpCU2T_(Fd$+*JFzd JFbJFfdJF:dC C0\ U3:dw!#hYD8C"L "DFV%2*UG`p=FQ1jf*DW!ru^=W1^Ipl7 .(6D!,M|YK` Upon completion of the enrollment process, approved providers are issued a Medicaid provider number and able to participate in the Georgia Medicaid program. Its important to keep your enrollment information up to date. For instructions and forms related to provider enrollment, access the Enrollment Forms page under the Provider Enrollment menu. You can decide how often to receive updates. Apply for Elderly & Disabled Waiver Program Serves frail, elderly, and disabled Georgians by providing coordinated services in their home or community. Pursuant to 42 C.F.R. - Posted 3/29/19. The Provider Enrollment Unit can be reached at the following: Fill out the Contact Us form. Intellectual & Developmental Disabilities, Applications for New & Existing Providers, Improving Health Outcomes Initiative Collaborative Learning Center, How to Report a Concern or Complaint about the Quality of Care or Safety. The Medicaid program canand does (through Medicaid DSH payments)subsidize the treatment of low-income, uninsured patients without making those individuals eligible for "medical assistance," as that phrase is used in the statute. sq(v~}m_xR3TM%n2> yxiST6T8 n%RA(G|rm5%S (=d8IS An official website of the State of Georgia. We are the front desk for people who need help navigating life changes and surprise obstacles in their homes, with their health, and in their communities. These manuals, listed below, will provide you with the definition of services and the associated standards. To apply for services contact a GAPP provider agency directly. p?.e^Tv+2,[P3-Nj` @Fy hO#+o"YI[:7 QO*$fL`m{s((P0(@L?:40QS`h)CVulT +C! 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^^+* Options Waiver Program (NOW) and Comprehensive Supports Waiver Program (COMP) <> Special Notice:Ending July 1, 2022, the Department of Community Health accepted public comment for a 30-day period on the New Options Waiver (NOW) and the Elderly and Disabled Waiver Program (EDWP) to renew both waiver programs. ) ]v&'0 pHin@ hf9^ 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. To provide services in other counties, you can find the appropriate AAA ataging.georgia.gov. For details about this waiver renewal, - Posted 02/16/21, New Care Waiver Program (ICWP) 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 0 means youve safely connected to the .gov website. Waiver Renewal Application An official website of the State of Georgia. 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). An official website of the State of Georgia. We can help connect you to privately and publicly funded resources from more than 26,000 community-based providers. Local, state, and federal government websites often end in .gov. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Complete and submit the applicable DBHDD New Provider Application, located at the following link: If required, when the DBHDD application review has been completed , a site visit will be conducted by the appropriate Regional Field Office. 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 . FAQ for behavioral health providers regarding prior authorization for individual and family therapy codes endstream l`JV``X or For questions, contactccsp.messages@dch.ga.gov. You must register and attend a New Provider Enrollment Forum, presented by the Georgia Collaborative ASO. For state Medicaid, a senior applicant is usually limited to either $841 / month or $1,133 / month in income and $2,000 in assets. Potential Provider Information . Official websites use .govA C;y}r_a^mTN\; y~%[Bd\;iPC#_I How you know. The CCSP Provider Consult is not a general information session. If the DCH application is denied, you are notified by DCH and advised of the next steps. 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. <> CCSP recipients have a monthly income between $400 and $2523 per month. How do I know if I am in the right place? Provider News. Independent A list of the applicable manuals is below. 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. 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. %PDF-1.5 % Applications are accepted by DCH in March and September of each year. Secure .gov websites use HTTPSA The following is a list of waiver programs in Georgia. User Information PDF Reader Required @ S You may access this form here: https://www.georgiacollaborative.com/providers/forms/. xUo1~??&q~TUZCML}@{@> +]aK?SYIJ',,{a=x:jTZ^*UhQ,e1 ,cz] x8!AUfG94a`)E,&Y 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 . 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. Available services include personal support, home health services, specialized medical equipment and supplies, counseling, emergency response systems, and home modifications. obtain a clear understanding of this Medicaid Waiver. To apply for services in one of these programs, please refer to the Department of Behavioral Health and Developmental DisabilitiesServices (DBHDD). . Waiver The access the EDWP Public Notice click here. 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. website belongs to an official government organization in the United States. (You can still use this guide if you dispense Part B drugs used with DMEPOS, such as inhalation drugs. Community 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. '<0c BAcaXC]va0y'A"_%:bIc(:'xO%.S I8J4a]H K c*G?^50&aInA /cEe`(00VoXUf,ncUe er7-c^QR(y 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). ; You don't want to bill Medicare for your services, but you do want enroll in Medicare solely to order and certify. Many state waivers also offer a single reimbursement of between $40 - $200 intended to cover any installation or startup fees associated with a PERS service. A list of the applicable manuals is below. Before sharing sensitive or personal information, make sure youre on an official state website. Email Us. Online Form. hmO6?}`w h! %PDF-1.5 ; You wish to provide services to beneficiaries but do not want to bill Medicare for your services. What is the best number to call to get started? https:// zoX-8IHH=mhX&Z4&kjI[%w$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. Primary: (404) 657-5468. Office of Analytics and Program Improvement, Medicaid Promoting Interoperability Program. 2023 Atlanta Regional Commission. The Program Specialist may occasionally send Banner messages through web portal for important notifications. Provides services to medically fragile children with multiple system diagnoses. Providers wanting to enroll in the Georgia Medicaid program can easily do so online using the Enrollment Wizard found within the Provider Enrollment menu. In addition to the waiver programs, Georgia offers other services through the regular Medicaid program designed to support people in their homes and communities. 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). 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. 3 . endobj 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. here Section 441.304, public notice is hereby given to the submission of a Medicaid 1915 (c) Elderly and Disabled (E&D) Waiver renewal. Use this guide if any of the following apply: If you already have an NPI, skip this step and proceed to Step 2. stream Both manuals can be found in the Medicaid web portal under Policy Manuals. A guide to Medicaid Waiver Programs in Georgia is now available. 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. <> 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.