The Home and Community Based (HCB) Waiver program provides services and support to elderly people or children and adults with disabilities to help them to remain in or return to their homes.
Attention HCB Waiver Providers only - Please see guidance for providers and use the referenced forms below to transition physical therapy, occupational therapy and speech language pathology services from the HCB Waiver to State Plan. This applies only to members in the HCB Waiver.
If you have any questions about transition of prior authorizations or billing, please email HPE. If you have questions about the State Plan therapy benefit, please contact DMS Division of Policy and Operations by email or by phone at (502) 564-6890.
(Aug. 22, 2016) - read the notice regarding HCB Waiver Providers - Conflict Free Case Management - New
(Aug 17, 2016) - read the notice regarding Home and Community Based Services Wavier Services - New
(Aug. 15, 2016) - Read the notice regarding the HCB Waiver 2 Announcement- New
Attention HCB Waiver Providers
The Department for Medicaid Services (DMS) will be completing a sampling of a new assessment for Home and Community Based Waiver (HCB). This will be conducted by DMS independent nurse assessors and is voluntary. The purpose of the sampling is to gather information about the impact of the new assessment tool and to assist in training on the implementation of the assessment. This assessment interview will not take the place of the yearly reassessment and will not impact eligibility or services.
Attention HCB Waiver Providers
(July 1, 2016) - On April 1, 2016, the new Home and Community Based (HCB) Waiver Program regulations, 907 KAR 7:010 and 907 KAR 7:015, became effective. However, DMS filed an e-regulation on June 30, 2016 amending the regulation to make it contingent upon Centers for Medicare and Medicaid Services (CMS) approval of the HCB Waiver Renewal. DMS is currently waiting for approval from CMS for the Waiver Renewal. Therefore, the HCB Waiver Program will continue to operate under the current Waiver as well as the regulations which may be found at 907 KAR 1:160 and 907 KAR 1:170. Notification of CMS approval will be provided once it is received. DMS anticipates approval in the next 15 to 30 days. If you have any questions, please contact DMS at 502-564-5560.
Attention CDO-PDS Waiver Members
The Department for Medicaid Services (DMS) issued a letter to Home and Community Based Waiver Members who use the Bluegrass Area Development District (BGADD) agency for Consumer Directed Option or Participant Directed Services. Medicaid members using BGADD for support broker or fiscal intermediary services will not be losing Medicaid eligibility or services. The Department for Aging and Independent Living (DAIL) will transition those services to a different agency with no disruption in service. For questions or concerns, please contact DAIL at 502-564-6930 and ask to speak to a CDO/PDS staff person. You may also call DMS at 502-564-5560.
View a copy of the DMS letter to CDO-PDS Waiver Members on BGADD
Home and Community Based Provider Letter #A-2; Adult Day Care Provider Letter #A- 42 - Survey of Non-Residential Waiver Providers (October 7, 2014)
Waiver Provider Letter #WP-A1 - New Federal Rule for HCB Settings
March 10,2014 - Notice: Adult day health care providers (Provider Type 43) - The CPT code 92506 (evaluation of speech, language, voice and communication) was deleted by CMS on Jan. 1, 2014. This code has been replaced with the following CPT codes:
- 92521-Evaluation of speech fluency (stuttering, cluttering).
- 92522- Evaluation of speech sound production (articulation, phonological process, apraxia, dysarthria).
- 92523- Evaluation of speech sound production (articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (receptive and expressive language).
- 92524- Behavioral and qualitative analysis of voice and resonance.
- 92610-Evaluation for Dysphagia
- 96105- Evaluation for Aphasia
- 96125- Cognitive performance testing
- 92507- Treatments for speech/auditory disorders
- 92526- Treatment sessions for dysphagia
The speech therapy provider must use the most descriptive CPT code for the service being provided to the member.
July 1, 2013 - Home and Community Based Waiver Program Provider Letter #A-1; Adult Day Healthcare Provider Letter #A-41 - HCBW/ADHC On-Site Provider Survey Changes
May 31, 2013 - The Department for Medicaid Services has contracted with Carewise Health to perform first-line monitoring/survey of the HCBW and ADHC services.
The Consumer Directed Option (CDO) is an alternative approach for delivery of non-medical, non-residential HCB services. These services now include:
- Support Broker
- Personal Care
- Attendant Care
- Unskilled Respite Care
- Goods and Minor Home Adaptation
For more information about Consumer Directed Option Services for HCB, visit the DMS CDO page.