Provider Qualifications

The Office of Developmental Programs (ODP) has committed to the individuals who receive services through the Consolidated and Person/Family Directed Support (P/FDS) Waivers and to the federal Centers for Medicare and Medicaid Services (CMS) that all Consolidated and P/FDS Waiver providers will be deemed qualified to provide their applicable services. The guidelines for achieving qualification are set forth in Appendix C of each of the waivers and must be met prior to rendering these services. Qualifications are completed by the specialty and are done on a statewide basis.

In order for a provider to become qualified, the following must occur:

  • The provider has to be registered in the Home and Community Services Information System (HCSIS). This includes the basic registration of the individual or agency contact information and sites, as well as registering for all of the services that they intend to provide.
  • The provider has to complete a Provider Qualification application on HCSIS. The application can be found at the following menu path after logging into HCSIS: Provider > Qualification > Application. Information regarding what specialties to qualify for, as well as the required supplemental documentation, can be found in the ODP Informational Packet #104-02.
  • Within seven days of submitting the online application, the provider must submit all required supplemental information as detailed in the ODP Provider Qualification Documentation Requirements chart (found in the Informational Packet linked above) to the Administrative Entity in the county where the provider's home office is located.
  • As ODP’s designee for provider qualification, the Administrative Entity will review the application and submitted materials and then make a determination whether the specialties of a provider are qualified. Please note: a determination of Disqualification, indicating that a provider can no longer provide Consolidated and P/FDS Waiver services, can only be made by the Deputy Secretary of the Office of Developmental Programs.

Qualifications are completed on an annual basis to ensure that the waiver services continue to meet the minimum qualification criteria. Providers that have questions regarding the Qualification process can review the ODP Online Provider Handbook (The handbook is not currently available as it is under review) or contact their local Administrative Entity.