Two home- and community-based services waivers are available for persons with acquired brain injury (ABI). These waivers could help Medicaid-eligible persons with ABI move to the community from a nursing facility or chronic or rehabilitation hospital and get community-based services.
About the Program
The Massachusetts Rehabilitation Commission (MRC) and MassHealth, in conjunction with UMass Medical School (UMass), offer two home- and community-based services waivers to help Medicaid-eligible persons with acquired brain injury (ABI) move to the community and get community-based services.
- ABI Waiver with Residential Habilitation (ABI-RH) - This waiver is 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 (ABI-N) - This waiver is for individuals who can move to their own home or apartment or to the home of someone else.
These waivers will serve 300 people over a period of three years.
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.
Services available in the ABI waivers include:
- day services;
- supported employment;
- community-based substance abuse treatment;
- occupational, physical, or speech therapy;
- specialized medical equipment;
- personal care;
- adult companion;
- home-accessibility adaptations;
- individual support and community habilitation; and
Additional ABI waiver services that will be contracted through MRC include:
- Residential habilitation services; and
- Transitional assistance services.
Regulations and standards established for ABI waiver providers can be found through the links below.
MassHealth Provider Regulations
- Administrative and Billing Regulations (130 CMR 450.000) file size 1MB
Massachusetts Rehabilitation Commission (MRC) Standards
- Division of Health Care Finance and Policy regulation 114.3 CMR 54.00 www.mass.gov/dhcfp.
ABI Waiver Provider Enrollment Process
Organizations or self-employed providers interested in offering ABI waiver services must enroll as a MassHealth provider, (unless they are providing only residential habilitation and/or transitional assistance services) and:
- complete a MassHealth ABI waiver provider enrollment package by completing and submitting the following forms:
- MassHealth Acquired Brain Injury Waiver Provider Application (PDF) ;
- Massachusetts Medicaid Program Provider Agreement and Acknowledgement of Terms of Participation for ABI Waiver Providers (PDF) ;
- Federally Required Disclosure Form [PE-FRD] ;
- Data Collection Form and Registration Instructions (POSC-DC-WU) (Rev. 06/14) ;
- MassHealth Trading Partner Agreement (PDF) file size 1MB ;
- Massachusetts Substitute W-9 Form ;
- meet the MRC standards for that service; and
- be credentialed by the UMass ABI Waiver Unit (use the Credentialing Supplement Tool ). Providers of certain services will be required to submit additional information (for example, licenses, certifications, or letters of verification).
Send completed provider enrollment documentation to:
UMass ABI Waiver Unit
333 South Street
Shrewsbury, MA 01545
Providers can get more information about how to enroll or assistance with the enrollment process by contacting the UMass ABI Waiver Unit by phone at 1-866-281-5602 or by e-mail at ABIinfo@umassmed.edu.
This information is provided by MassHealth.