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I am a Medicaid I/DD Waiver Provider

Approved waiver providers are paid by Medicaid to deliver direct services to Medicaid I/DD Waiver participants in compliance with all waiver requirements, federal and state laws, and waiver standards. Providers incorporate principles of person centered planning into the delivery of services and supports.

Trainings

DDD holds at least two (2) HCBS Medicaid I/DD Waiver Provider Trainings each year to update waiver providers on the activities of the division, any changes to state and federal regulations, and information about the Medicaid I/DD Waiver, as well as to provide technical assistance.

All available past training material, videos, or webinars can be accessed through Archive: Training for Providers.

Monitoring

Home and Community-Based Services (HCBS) Final Rule for Community Integration

Current providers that were delivering services before the final rule was issued in 2014 must work toward meeting the Centers for Medicare and Medicaid (CMS) HCBS Final Rule for Community Integration to deliver services in fully integrated community settings. Providers will complete remediation activities as described in Hawaii’s state transition plan, My Choice My Way.

New provider applicants must meet the final rule requirements prior to approval to become a Medicaid I/DD Waiver provider. There is no transition period for a new provider applicant.

Providers should review the most recent Medicaid Waiver Standards, CMS Guidance, DDD Final Rule Resource Page, and the Hawaii state transition plan, My Choice My Way.

Adding a New Service

A waiver provider in good standing may request to add services to its service array. “Good standing” means the provider has:

  1. a current signed Medicaid Provider Agreement with the Department of Human Services, Med-QUEST Division (MQD);
  2. meets the Medicaid waiver requirements as determined through the monitoring process and;
  3. has received approval from DDD for its corrective action plan, if applicable.

To request adding a service, complete and submit a DDD Medicaid I/DD Waiver Provider Service Expansion Application (*coming soon*).

DDD will review the provider’s application and responses to supplemental service-specific questions. The Provider must demonstrate the capacity and qualified staff to deliver the additional services requested and the additional services are delivered in compliance with the CMS HCBS Final Rule for Community Integration. DDD will also review the provider’s recent monitoring results in making a final determination.

Changing Waiver Provider Information

It is important that all waiver providers update the DDD Community Resources Branch (CRB) of any changes in provider information.  Changes in provider information may include:

  • Waiver provider name
  • Primary waiver contact person
  • Contact information: phone number, fax number, email address, mailing and physical address, etc.
  • Adding geographical locations or service addresses

All changes in provider information should be emailed to CRB immediately at [email protected].

Questions

If you are a current Medicaid I/DD Waiver provider and have questions, you may contact the DDD CRB at 808-733-2133 or [email protected].

Resources

Waiver Standards

2021 Waiver

2021 Waiver, Amendment #7

2021 Waiver, Amendment #4

2021 Waiver, Amendment #3

2021 Waiver, Amendment #2

2021 Waiver, Amendment #1

2021 Waiver Application

2016 Waiver

Rate Models from Burns & Associates

Previous Rate Models from Burns & Associates