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Reassessment Packet

Home and Community Based Services (HCBS) providers may choose to participate in the reassessment of participants of the Department of Health and Senior Services, Division of Senior and Disability Services (DSDS) that they serve. This service only applies to personal care, aged & disabled waiver and adult day care services authorized by the DSDS. Additional information is available at http://health.mo.gov/seniors/hcbs/memos.php

 

STEP 1:
You must be actively enrolled in one of the following provider types prior to submission of the application for Reassessments:
– In-Home Services
– Consumer Directed Services
– Adult Day Care
– Assisted Living Facility
– Residential Care Facility

 

STEP 2:
In addition to the requirements in Step 1, a representative of the company that meets the reassessment minimum requirements must have participated in the Dept. of Health and Senior Services (DHSS) Reassessment training and have a valid certificate prior to submitting a Reassessment application to MO Medicaid. Information regarding training can be found on the DHSS website at https://health.mo.gov/seniors/hcbs/reassessment/index.php. After both of the above criteria have been met, the following application packet must be submitted to be considered for enrollment into the MO Medicaid Reassessment program:

Reassessment Packet

  1. Reassessment Provider Questionnaire
  2. MMAC HCBS Enrollment Application Form
  3. Terms and Conditions
  4. Participation Agreement
  5. Business Organizational Structure
  6. Electronic Funds Transfer Form and copy of a voided check or bank letter
  7. Notification from the Internal Revenue Service of the applying provider’s assigned Federal Employer Identification Number. – W-9s will not be accepted.
  8. Current documentation from DSDS of completed Reassessment Training registration and attendance (email notice, memo, certificate)
  9. On a separate sheet, include the reassessor’s full name, date of birth, ssn, current FCSR screening and a copy of RN licensure if applicable.

 

Providers may submit their application packet via fax or e-mail.

The preferred method of submission is fax, however, we can accept emailed documents in PDF or Word format if providers are unable to fax.

MMAC does not accept photos of documentation taken with a cell phone or camera for enrollment purposes.

 

Fax Number: 573-634-3105

Email: MMAC.IHSContracts@dss.mo.gov