MassHealth offers certain home- and community-based service waivers that make long-term community services available to eligible individuals. Individuals in a waiver can receive both traditional MassHealth services and the additional services available. All waiver participants will work with a case manager to develop a service plan that will reflect the waiver services and support they need in the community.
Providers may enroll in MassHealth to provide some of the services under the four home- and community-based service waivers described below.
Two Waivers to Help Persons with Acquired-Brain Injury (ABI)
- ABI Waiver with Residential Habilitation – for individuals who need service in a provider-operated residence that has supervision and staffing 24 hours a day, seven days a week.
- ABI Waiver with No Residential Habilitation – for individuals who can move to their own home or apartment or to the home of someone else.
Two Money Follows the Person (MFP) Waivers
- MFP Residential Supports (MFP-RS) Waiver – for individuals who need service in a provider-operated residence that has supervision and staffing 24 hours a day, seven days a week.
- MFP Community Living (MFP-CL) Waiver – for individuals who can move to their own home or apartment or to the home of someone else.
- Adult Companion
- Assisted Living Services
- Chore Service
- Community/Residential Family Training
- Day Services
- Home Health Aide
- Independent Living Supports
- Individual Support and Community Habilitation
- Occupational Therapy
- Peer Support
- Personal Care
- Physical Therapy
- Prevocational Services
- Skilled Nursing
- Specialized Medical Equipment
- Speech Therapy
- Supported Employment
- Supportive Home Care Aide
Additional waiver services that are contracted through the Massachusetts Rehabilitation Commission include:
- Residential Habilitation (group home)
- Shared Living – 24-Hour Supports
- Shared Home Supports
- Vehicle Modification
- Home Accessibility Adaptations
- Transitional Assistance Services
MassHealth regulations and Massachusetts Rehabilitation Commission standards that describe waiver service and provider requirements for the waiver providers may be found through the links below.
MassHealth Provider Regulations
- Administrative and Billing Regulations (130 CMR 450.000) file size 1MB
- Home- and Community-Based Services Waiver Services (130 CMR 630.000)
Massachusetts Rehabilitation Commission Standards
- Money Follows the Person Waiver Services (101 CMR 357.00)
- Acquired Brain Injury Waiver and Related Services (114.3 CMR 54.00)
Waiver Provider Enrollment
Most organizations or self-employed applicants interested in providing the listed waiver services must enroll as a MassHealth provider. Those providing only residential habilitation, shared living – 24-hour supports, shared home supports, transitional assistance, home accessibility adaptations, or vehicle modification, must contract through the Massachusetts Rehabilitation Commission (MRC) to provide these services.
The MassHealth provider enrollment process includes completing and submitting the following forms:
- MassHealth Home- and Community-Based Services (HCBS) Waiver Provider Application (APP-HCBS)
- Massachusetts Medicaid Program Provider Agreement and Acknowledgement of Terms of Participation for Home- and Community-Based Services Waivers (GEN-HCBS) (Rev. 08/13)
- Federally Required Disclosure Form [PE-FRD]
- Data Collection Form and Registration Instructions (PDF)
- MassHealth Trading Partner Agreement (PDF) file size 1MB
- Authorization for Electronic Funds Transfer (EFT) of MassHealth Payments
- Massachusetts Substitute W-9 Form
- Home and Community Based Services (HCBS) Waiver Provider Enrollment Checklist
In addition, providers must meet the MRC standards for the service, found on the MRC website at http://www.mass.gov/eohhs/gov/departments/mrc/.
The provider enrollment process begins with the submission of the completed MassHealth provider application along with the other forms listed above to the University of Massachusetts (UMass) Waiver Unit. The UMass Waiver unit uses the following Home- and Community-Based Service Provider Enrollment form (pdf) to guide providers through the application process. Providers of certain services will be required to submit additional information (for example, licenses, certifications, or letters of verification).
Current ABI Waiver providers should complete only the Home- and Community-Based Service Waiver Provider Checklist and supporting documentation. The additional forms listed above must be completed only if the provider is reporting changes. Contact the UMass Waiver Unit for assistance in determining which information is required.
Send the completed provider enrollment documentation to:
University of Massachusetts
Home and Community Based Services Provider Network Administration Unit
333 South Street
Shrewsbury, MA 01545
Providers may obtain more information about how to enroll or assistance with the enrollment process by contacting:
UMass Provider Network Administration Unit
This information is provided by MassHealth.