Opublikowane: 10-04-2021

Home And Community Based Services Provider Agreement Form


The recipient may benefit from these benefits at home and in the municipality, provided they are medically necessary, cost-neutral and complete the institution of care or the urgent care provided in hospitals. If you offer any of the following services, you must provide a copy of your general liability insurance certificate, referred to as „DHS Provider Eligibility and Compliance” as the holder of the certificate on the document at POSTFACH 64987, St. Paul, MN 55164-0987: For information on how to be one of the following HCBS providers or apply, please contact the registration provider at (916) 552-9105. Email requests can be sent to: ProFacWAIVER@dhcs.ca.gov. For important information on the revalidation process and the impact on your registration with MHCP, read the „Revalidation” section of the MHCP Operator Requirements section under the supplier`s database. Background Study If you are applying for the provision of one of the following unauthorized services, you must complete the Request for Licensing Agency ID Number (DHS-3891) form (PDF) and submit a context study for all owners and managers identified on the „Disclosure of Property and Control Interest” (DHS-5259) form (PDF) or in the „Authorized Owners” section of the MPSE portal. You must wait until you have received a notification from the Department of Human Services (DHS) authorization before authorizing the person to provide direct care services to a member of the MHCP. MHCP is required to comply with the final federal control rules of the Centers for Medicare – Medicaid Services (CMS). All participants work with a case manager/service coordinator to develop their individual service plan, which includes their goals and waiver services and supports the needs of participants in the community.

Providers can register with MassHealth to provide some of the services described below as part of the four home and community-based service waiver declarations. The steps and instructions in this section apply to services for one of the following programs: masshealth rules, Massachusetts Rehabilitation Commission guidelines and Department of Development Services guidelines that describe the requirements of waiver services and providers for waiver providers, are below. People who receive Medicaid Home and Community-Based (HCBS) services will soon have the same opportunities as those who do not receive these services. Thanks to the new federal centers for Medicare and Medicaid Services (CMS), people who receive Medicaid HCBS have the right to live in the most integrated environment and to have full access to community life.