Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials)

What this rule requires your agency to do

• 1PT 24 Personal Care agency credentialing requires IRS Form W-9, General Excise Tax (GET), NPI (Taxonomy 253Z00000X In-Home Supportive Care), an MQD site visit, and a Fingerprint Criminal Background Check.(Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials))
• 2Where a provider has multiple Medicaid provider numbers, providers must bill for authorized services rendered using the provider ID assigned to the provider type and island of service; QI Health Plans must prior authorize using the corresponding provider ID.(Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials))
• 3Once active in HOKU, providers are required to update, change, and revalidate agency information including licenses directly online in the HOKU system.(Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials))
• 4HHA and PCS providers are required to have a separate Medicaid provider number for each of: (1) home health agency services; (2) Home Care/Personal Care services; (3) private duty nursing services; and (4) I/DD waiver services.(Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials))
• 5PT 24 Home Care/Personal Care providers must be licensed/certified by the Department of Health and must have separate Medicaid provider numbers and NPI numbers by island (and for Kona and Hilo on Hawaii island as needed).(Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials))
• 6HHA and PCS providers are required to participate in the EVV program beginning January 1, 2021; EVV participation pursuant to Section 1903 of the Social Security Act (42 U.S.C. 1396b) (21st Century Cures Act) is required for HHA and PCS providers in the Medicaid program.(Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials))
• 7PT 24 Home Care/Personal Care agencies must be licensed as a Home Care Agency for each island by DOH/OHCA (State Licensing Section / HCAL).(Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials))
• 8New providers must enroll as a Hawaii Medicaid Provider on the HOKU web-based provider enrollment system, completing a separate enrollment for each required Medicaid provider number.(Med-QUEST Provider Memo QI-2119 [Replaces QI-1924] — Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies Under the 21st Century Cures Act (incl. Appendix A: EVV Provider Types and Credentials))