Medicaid Provider Enrollment Overview

Washington offers 6 Medicaid waiver programs for home care agencies. The state Medicaid program is administered by Washington State Health Care Authority (HCA). Currently, Washington is actively enrolling new home care providers.

The average enrollment timeline is 90-120 days from initial application to receiving your first client. With high demand for home care services, Washington represents an excellent opportunity for agencies looking to serve Medicaid clients.

Washington Medicaid Waiver Programs

Home care agencies in Washington can enroll in the following waiver programs. Each program serves different populations and has specific service requirements.

1

Community First Choice (CFC)

1915(k) Waiver

Personal care services

2

COPES Waiver (Community Options Program Entry System)

1915(c) Waiver

Services for nursing home eligible

3

New Freedom Waiver

1915(c) Waiver

Self-directed services

4

Basic Plus Waiver

1915(c) Waiver

DD basic services

5

Core Waiver

1915(c) Waiver

DD core services

6

Community Protection Waiver

1915(c) Waiver

DD community protection

Washington Provider Requirements

To become a Medicaid provider in Washington, your home care agency must meet the following requirements:

  • Washington business registration
  • In-Home Services Agency license from DSHS
  • Criminal background checks (DSHS)
  • Professional liability insurance
  • HCA provider standards
  • Quality management system

Step-by-Step Enrollment Process

Follow these steps to enroll as a Medicaid waiver provider in Washington:

1

Obtain Washington in-home services agency license

2

Apply for NPI

3

Complete Washington ProviderOne Enrollment

4

Register in PRISM

5

Contract with MCOs (if managed care area)

6

Complete required training