№ files_lp_4_process_3_079753
Administrative checklist and regulatory reference document outlining documentation, qualifications, compliance obligations, and service categories for self-employed providers applying to deliver MassHealth HCBS waiver services under the Acquired Brain Injury and Moving Forward Plan programs in Massachusetts.
Program: MassHealth Home- and Community-Based Services (HCBS) Waivers
Related Waivers: Acquired Brain Injury (ABI) Waiver; Moving Forward Plan (MFP) Waiver
Country: United States
State: Massachusetts
Administering Program: MassHealth (Massachusetts Medicaid Program)
Related Agencies: MassAbility; Department of Developmental Services (DDS); Department of Public Health (DPH); Department of Children & Families (DCF); Department of Mental Health (DMH)
Document Type: Provider enrollment checklist and requirements guide
Purpose: Documentation requirements and eligibility criteria for self-employed providers seeking enrollment in HCBS waiver services
Target Audience: Self-employed applicants applying to become HCBS waiver service providers
Required Forms: MassHealth HCBS Waiver Provider Application; Massachusetts Medicaid Program Provider Agreement; MassHealth Trading Partner Agreement; Substitute W-9 Form; CORI Request Form; Federally Required Disclosures Form
Compliance Requirements: CPR and first aid certification; tuberculosis screening and testing; HCSIS registration; incident reporting; client encounter documentation for billing
Payment Method: Electronic Funds Transfer (EFT) authorization for MassHealth payments
Service Areas: Boston/Metro; Central; Southeast/Cape/Islands; Northeast; Western regions of Massachusetts
Population Served: Individuals with acquired brain injury; older adults; individuals with physical disabilities; individuals with intellectual disabilities; individuals with behavioral health conditions; individuals with substance use disorders
Services Listed: Adult Companion; Assistive Technology; Chore; Community/Residential Family Training; Homemaker; Individual Support and Community Habilitation; Orientation and Mobility Services; Personal Care; Specialized Medical Equipment; Occupational Therapy; Physical Therapy; Speech Therapy
Regulatory References: MassHealth All Provider Regulations (130 CMR 450.000); MassHealth Rates for Home and Community Based Waiver Regulations (101 CMR 359.000); MassHealth Home and Community Based Waiver Services (130 CMR 630.000)
Information Systems: Home and Community Services Information System (HCSIS)
Reporting Obligations: Incident reporting through HCSIS and mandatory reporting of abuse or neglect to appropriate Massachusetts agencies
Screening Requirement: Tuberculosis disease screening tool for staff
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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