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HCBS Waiver Provider Application Process

If you are interest in becoming a provider of services for the DDA Home and Community Based Services Medicaid Waiver program the instructions to complete a Waiver Provider Application and other pertinent information you will need to know for the application process. Prospective providers should ensure that they meet the requirements to become enroll as a Home and Community Based Services (HCBS) Medicaid Waiver Provider as outlined in General Provisions. Interested organizations and licensed clinicians must refer to the waiver service descriptions and rules for detailed requirements to become enrolled as a Home and Community Based Services (HCBS) Medicaid Waiver Provider.  Please read the materials carefully to determine what services you or your organization may be eligible to provide.

Prior to submitting an application prospective provider must send a letter of interest to DDA to enroll as a Home and Community Based Services (HCBS) Medicaid Waiver Provider to letterofintent.potentialproviders@dc.gov In the subject line of the email please include the name your company followed by Letter of Intent. For example: Acme Agency Letter of Intent.

The letter must include an introduction of your company (organization and/or licensed clinicians) including, what services that is currently being provided in the community and in what state, the name of the company, contact information including phone and email address, how many years of experience that you have providing services and supports with persons with Intellectual and Developmental Disabilities and what services your company would like to provide as a DDA Home and Community Based Services (HCBS) Medicaid Waiver program.

The completed application with original signatures and all required documentation must be mailed to the following address:

Medicaid Waiver Provider Application Processing
The Department on Disability Services
Developmental Disabilities Administration
1125 15th Street NW, 8th Floor
Washington, DC 20005

Do not submit an application prior to attending the mandatory prospective provider meeting. Applications submitted prior to the attendance of the prospective provider meeting will not be accepted.

If you need additional assistance in completing your application, please contact Customer Services at 202-442-8686.
Provided below is the information on the submission of the Medicaid waiver application for new and existing Home and Community Based Waiver providers.

Application for Medicaid Enrollment

Under the Authority of Title 29DCMR Chapter 19 Home and Community-Based Waiver Services for Persons with Mental Retardation and Developmental Disabilities.

New Medicaid Home & Community-Based Waiver Providers

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 agency’s compliance with the specific rules for each of the waiver services the agency is requesting approval to provide. Applications submitted prior to the attendance of the prospective provider meeting will not be accepted.

A prospective provider must  complete the following steps:

1. Complete and sign the District of Columbia’s Medicaid Provider Application (DCMED 4000).
2. Attach all required supporting documentation as specified in the application instructions.

NOTE: New agencies that are interested in enrolling to become a qualified provider through the Home and Community Based Medicaid Waiver program must review and comply with the DDS Provider Readiness Review Policy and Procedure, Provider Certification Review Policy  , Title 29 Public Welfare of DCMR: Chapter 19, Section 1900, General Provision and the Home and Community Based Waiver rules for the specific service(s).

Existing Home & Community-Based Medicaid Waiver Providers

Existing Home & Community-Based Medicaid Waiver Providers

As an existing Home & Community Based Medicaid Waiver Provider, you are required to submit a Supplemental Application and submit supporting documentation in the form of policies and procedures, licensure and/or certification that will demonstrate your compliance with the specific rules and regulations for the waiver services which you are requesting to provide before an approval for enrollment is issued. Existing providers may add new services if they have been providing services to persons enrolled the HCBS waiver for more than six months and are in good standing with DDS/DDA policy and procedures; have passed initial PCR, if applicable; are not currently on any sanctions opposed by DDS/DDA; DHCF; DHLR: or any federal, state, and local entities governing HCBS waiver providers and program.

The following must be completed:

1. You must complete and sign the District of Columbia’s Medicaid Home & Community-Based Services Waiver Supplemental application.
2. Follow the instructions found in the application and attached all required supporting documentation.
3. Complete steps one and two of the Application approval process as outlined below.
4. DDA will forward a copy of the approval/denial letter from DHCF for providers the successfully complete steps one and two.
 

Application Review Process

The Department on Disability Services, Developmental Disabilities Administration (DDS/DDA) and the Department of Health Care Finance (DHCF) has a  three step application review process.