Under the Authority of Title 29DCMR Chapter 19 Home and Community-Based Waiver Services through the Department on Disabilities Services (DDS).
DDS/Developmental Disabilities Administration (DDA) and the Department of Health Care Finance (DHCF) has a three-step application review process for prospective service providers.
Prospective providers must send a letter of interest to DDA to enroll as a Medicaid provider of Waiver services. All letters of interest are to be sent to the following email address: [email protected]
In the first step, the Provider Relations Specialist reviews the application to determine whether an applicant submitted the required documentation as outlined in the Medicaid Provider Application and General Provisions. Applicants that submit fail to submit the required documentation will receive a denial letter from the Department on Disability.
Applicants that meet the requirements will proceed to the second step in the approval process.
Following a determination that the applicant submitted the required documents, the Provider Relations Specialist will schedule a date and time to conduct the face to face interview with owner(s) and key personnel. The review panel, which consists of representative from various business units in DDA, will assess the provider’s knowledge and ability to provide the service(s) identified in the application.
Applicants who are unable to present knowledge and expectations for service delivery will receive a denial letter.
Applicants who are determined to have the knowledge, ability, and systems in place to provide service(s) will receive notification from DDS that the application has been forwarded to DHCF for approval/denial (Step 3).
For the final step, DHCF will review the application and conduct review the Applicants records and proposed system to ensure service(s) are provided according to Federal and District of Columbia rules and regulations. The Applicant will receive an approval or denial letter from DHCF.
Within 60 days of service initiation, the Developmental Disabilities Administration will conduct a Provider Certification Review by representatives from the Quality Management Division. An on-site review is required to evaluate the provider’s implementation of all relevant policies and procedures and quality of overall service delivery. This on-site review will consist of a review of records and documentation, interviews with individuals receiving services and staff, and observation of service delivery.
Failure to meet the minimum on-site review standards may result in revocation of the Medicaid provider agreement.