Medical Assistance Waiver Provider Participation
If the Agency serves participants in an Office of Long-Term Living waiver or the Act 150 program, sets out what it must have and keep doing as an enrolled provider: the required written policies, licenses and insurance, new provider training within 180 days, two-yearly requalification, approved service plans before services, change notices, monitoring and corrective action plans, a quality management plan, and five-year record retention.
About this policy
- Policy number
- PA-HC-BUS-03
- Version
- 1.0
- Main rule
- 55 Pa. Code §52.11
- Library
- Pennsylvania home care · 49 policies
- Category
- Business
- Sections
- 15
In short
- Some of our consumers get services through Medical Assistance waiver programs. Their services must match their approved service plan.
- You will be trained on each waiver participant’s service plan before you serve them.
- Do only the tasks and hours in the plan. If the participant needs something different, call the office.
- Waiver participants can call the Participant Helpline at 1-800-757-5042 with concerns.
What's inside
15 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (55 Pa. Code §52.11)
- 5. Ongoing Provider Duties
- 6. Records, Audits, and Insurance
- 7. Managed Care Organizations
- 8. Responsibilities
- 9. Records and Compliance Monitoring
- 10. Staff Training
- 11. References
- 12. Related Policies and Forms
- 13. Approval
- 14. Revision History
An inspector may ask
- Which waiver programs are you enrolled in, and when did you last submit your provider requalification?
- Show me your certificates of commercial general liability and workers’ compensation insurance.
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