Home and Community Based Services (HCBS) waiver providers are required to enroll in the MassHealth program with an assigned MassHealth Waiver Provider number. If a company provides services to individuals who are enrolled in the Frail Elder HCBS Waiver, providers must complete specific MassHealth enrollment forms.
Interested ASAP providers should download and review the documents. The links are provided below.
Please note the contracting ASAP will provide specific instructions prior to submitting any documentation.
Frail Elder Waiver HCBS Enrollment Links:
Frail Elder Home- and Community-Based Services Waiver Provider Application
Massachusetts Medicaid Program Provider Agreement and Acknowledgement of Terms of Participation
Provider Enrollment Data Collection Form and Registration Instructions
Federally Required Disclosures: Entities
What is the Federally Required Disclosure Form (FRDF) for Entities?
Federally Required Disclosures – Individual Practitioners