Home and Community Based Services - Provider Information (Partners & Providers) | Missouri Department of Health and Senior Services

Regulation & Licensure (DRL) – EDL, FCSR, GCW, ADC

DRL within DHSS is responsible for areas impacting health and safety, determining compliance with state and federal regulations through inspection of premises, care and services. The division also issues licenses for various service providers.

Employee Disqualification List (EDL) [NEEDS LINK] is a listing of individuals who have been determined to have:

Abused or neglected a resident, patient, client or consumer
Misappropriated funds or property belonging to a resident, patient, client or consumer
Falsified documentation verifying delivery of services to an in-home services client or consumer

Family Care Safety Registry (FCSR) [NEEDS LINK] helps to protect children, seniors, and people with disabilities by providing background information. Provider agencies are required to conduct background screenings by checking the FCSR, which checks seven Missouri databases.

Good Cause Waiver [NEEDS LINK] may be applied for by an individual who has been disqualified from employment with certain provider types.

Adult Day Care (ADC) programs offer supportive services to the participant as well as the family by providing care and supervision in a protective environment during the day.

MO HealthNet Division (MHD) – EVV, Training, Billing, NEMT

MO HealthNet Division (MHD) within the Department of Social Services (DSS) offers health care coverage for eligible Missourians.
Questions? Email: ask.MHD@dss.mo.govoffers

Electronic Visit Verification (EVV) was mandated by the 21st Century Cures Act for all Medicaid personal care services. Benefits of using EVV include improved health and welfare of individuals through validation and monitoring of delivery of services; reduction in fraud, waste and abuse; elimination of paper documents to verify services; enhanced efficiency and transparency of services; and more robust data collection and analysis capabilities.

MHD Provider Education (573-751-66830) provides training to MO HealthNet providers. They offer training on navigating provider resources, proper billing methods, procedures for claim filing via eMOMED and other topics. 573-751-6683.

Non-Emergency Medical Transportation (NEMT) provides free transportation for Medicaid eligible participants to and from scheduled MO HealthNet covered services such as medical and behavioral appointments.

Family Support Division (FSD) – Medicaid Eligibility

Family Support Division (FSD) within DSS administers public assistance programs, Medicaid, blind services and other basic needs. FSD determines Medicaid eligibility, including spenddown, which refers to the amount of medical expenses that are a participant’s financial responsibility.

Home and Community Based (HCB) Medicaid may assist with a participant’s spenddown if certain criteria are met. A determination must be made for the need and availability of Aged and Disabled Waiver (ADW) services before FSD can apply the higher HCB. The Division of Senior and Disability Services coordinates with FSD to determine HCB Medicaid using the HCB Referral Form (IM-54A), which provides standard interagency communication.

Missouri Medicaid Audit Compliance (MMAC)

Missouri Medicaid Audit And Compliance (MMAC) (573.751.3399) with DSS is responsible for administering and managing Medicaid audit and compliance initiatives and managing and administering provider enrollment contracts under the Medicaid program.

HCBS Provider Forms

Office of Special Investigations

Office Of Special Investigations (OSI) with DSDS is comprised of criminal investigators who specialize in conducting criminal investigations of abuse, neglect and financial exploitation.

OSI Map

DHSS Proofpoint Email Encryption

All Protected Health Information (PHI) must be exchanged securely. Proofpoint software allows providers and vendors to submit information to DSDS electronically without compromising participant confidentiality.

Proofpoint Email Encryption

DHSS Emergency Preparedness

The Office Of Emergency Coordination with DHSS works to ensure plans and systems are in place to promote the health and safety of Missourians during public health emergencies.

Disaster and Emergency Planning

Additional Resources

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