Maryland provider enrollment
What Maryland requires before you can deliver home and community-based waiver services, in the order the state actually requires it. Every claim links to the official page it came from.
Provider rules change often — confirm fees and deadlines against the linked sources before you rely on them.
Maryland's application has a timing trap that has nothing to do with how good your program is. Background checks must be requested at least two weeks before you submit the application, a check only counts as current if it comes back from the Criminal Justice Information System no more than 45 days after it was requested, and if the required checks have not reached DDA headquarters within 30 days of DDA receiving your application, the application will not be approved. Those three clocks overlap, and the fingerprinting appointment is the piece you control least. Start there — with DDA's Agency Authorization number 1500001484 and ORI number MD003105Y, and with "Government Licensing or Certification" checked on the Livescan form. Everything else in the packet is work you can schedule: a program service plan and a quality assurance plan under COMAR 10.22.02, financial documents demonstrating you can actually render the services, resumes for leadership, and the governing body, staff training, criminal history, and policies and procedures forms.
Approves all persons, agencies, and business entities that want to render services to DDA waiver participants. Applications are accepted only from an individual who will directly render the service or from an agency's CEO or director.
Visit siteReview applications and answer questions specific to your DDA addendum or services. Coordination of Community Services applications may also be reviewed by DDA's State Director of Coordination of Community Services.
Visit siteAll Medicaid enrollments, re-enrollments, and supplements are submitted here. DDA cannot submit paper Medicaid applications on providers' behalf and cannot assist with ePREP technical issues.
1-844-463-7768Visit siteDDA instructs applicants to request the required background checks and child protective service clearances at least two weeks before submitting the application. Use Agency Authorization number 1500001484 and ORI number MD003105Y, and check "Government Licensing or Certification" on the Livescan form.
SourceA current background check is one received from CJIS no more than 45 days after it was requested. If the required checks are not received by DDA headquarters within 30 days of the receipt of your provider application, the application will not be approved. Include the receipts for the criminal history checks and documentation of any follow-up contacts.
SourceAgency applicants must submit a program service plan and quality assurance plan as required by COMAR 10.22.02, demonstrating capacity to provide the supports and services sought, and must demonstrate financial capability through all required financial documents.
SourceAn applicant may not employ or contract with any individual or entity excluded from participation in any federal health care program. Check the federal List of Excluded Individuals and Entities and the state list of excluded Medicaid providers before you hire or contract.
SourceReview DDA's application and approval policy, request background checks, complete the DDA Provider Application with its forms and attachments, then enroll with Medicaid through ePREP using your Tax ID.
Application system: DDA Providers — applications, policy, and checklist
DDA directs applicants to its policy on Application and Approval Processes for Qualified Supports/Services Providers in DDA's Home and Community-Based Waivers, the eligibility requirements for qualified providers, and the completion instructions — before downloading anything.
SourceThe DDA Provider Application, the Qualified Support/Services Provider Agreement to Conditions of Participation, and the Provider Checklist. Save a copy of each.
SourceCJIS criminal history record checks are required for the applicant and first-line managers. If you will serve children, child protective services clearances are required for the applicant and first-line managers as well.
SourceAll applicants complete pages 1–11 with attachments on page 12. Individual applicants may complete Section II or substitute a resume; agencies skip Section II, provide resumes for CEOs, directors, and all managers or supervisors overseeing waiver services, and complete the Agency Questionnaire on pages 14–17 with attachments on page 18.
SourceAgencies — initial or renewal — must complete the Governing Body (Board of Directors) form, Staff Training form, Criminal History form, the Organized Healthcare Delivery System form if applicable, and the Policies and Procedures form. Residential child care applicants provide the information on page 19.
SourceAll Medicaid enrollments, re-enrollments, and supplements go through ePREP, where DDA providers use their Tax ID as the identifier. Once you have a Medicaid provider number you can register for the eMedicaid portal to verify eligibility, pull remittance advice, and submit claims.
SourceApplications must demonstrate that the individual and the agency staff rendering or overseeing waiver services meet educational, license, certification, and experience requirements. CPR and first aid training is required for individual applicants and agency staff.
SourceApplicants for children's licensure must explain their training, skills, and experience serving children and differentiate children's needs from adults'. Applicants proposing to serve adults explain the equivalent for adults.
SourceBehavioral support applicants must identify training and experience in applied behavior analysis, functional analyses and assessments, and behavior plans — and attach examples of plans they have developed.
SourceNursing applicants must include training and experience completing Health Risk Screening Tools and nursing assessments, providing health case management, supervising certified nursing assistants and certified medication technicians, and treating individuals with chronic health conditions — and identify the screening tools and assessments used.
SourceApplications from agencies proposing to render Targeted Case Management, known in Maryland as Coordination of Community Services, may be reviewed by DDA's State Director of Coordination of Community Services in addition to regional Provider Services staff.
SourceExcept for the applicant and first-line managers, DDA does not require actual submission of criminal history or background checks for other staff, contractors, and volunteers unless specifically requested. Instead you attest through the Conditions of Participation agreement and the Staff Criminal History Form that the checks occurred with appropriate results.
SourceUnder Health-General Article §§19-1901 through 19-1912, criminal history record checks — and child protective service clearances where children are served — are required for all staff, contractors, volunteers, and other persons who will have direct contact with waiver participants, before your agency approves them to render services. You may not employ or contract with anyone whose criminal history indicates behaviors potentially harmful to participants, per COMAR 10.22.02.11B.
SourceCPR and first aid training is required for individual applicants and agency staff, and licensed providers complete the Staff Training Form built on COMAR 10.22.02.11C and D.
SourceTwo weeks before submission to request the checks, 45 days for a check to remain current from its request date, and 30 days from DDA's receipt of your application for the results to arrive at headquarters. The application fails on that schedule before it is ever judged on merit.
SourceSite visits occur to provider-operated sites as part of DDA's approval process, so a site that is not ready is a schedule risk as well as a compliance one.
SourceThe DDA Provider Application covers new applicants, providers renewing approval, providers seeking to render a waiver service not already approved, and applicants for demonstration or special projects authorized under COMAR 10.22.
SourceRe-enrollments and supplements are submitted in ePREP like the original enrollment. DDA cannot file them for you, and cannot resolve ePREP technical problems — that is the ePREP call center's job.
SourceMaryland does not publish these in a form we could verify, so we have not guessed at them. Ask directly — and if an answer here would help other providers, tell us and we will add it with its source.
Ask: Your DDA regional Provider Services office
Ask: Your DDA regional Provider Services office
Ask: Your DDA regional Provider Services office
Ask: ePREP call center, 1-844-463-7768
The authoritative walk-through: background check numbers and deadlines, which pages apply to you, and the required forms.
Visit siteThe approval policy, eligibility requirements, application, conditions of participation, and provider checklist.
Visit siteThe application itself, including the agency questionnaire and attachment lists.
Visit siteThe addendum for participation in the Maryland Medical Assistance Program.
Visit siteHow DDA providers enroll in Medicaid, and where DDA's help ends.
1-844-463-7768Visit siteTiming on the background checks. Request them at least two weeks before you submit; a check is only current if CJIS returns it within 45 days of the request; and if the results have not reached DDA headquarters within 30 days of DDA receiving your application, it will not be approved.
Only an individual proposing to directly render the services, or an agency's chief executive officer or director. Applications must be signed and dated.
No — only for yourself and your first-line managers, unless DDA specifically requests more. For everyone else with direct participant contact you certify that the checks occurred with appropriate results, through the Conditions of Participation agreement and the Staff Criminal History Form.
No. All Medicaid enrollments, re-enrollments, and supplements must be submitted in ePREP, DDA can no longer submit paper Medicaid applications on providers' behalf, and DDA cannot assist with ePREP technical issues. Call the ePREP call center for those.
Yes, the same one. The DDA Provider Application is used by new applicants, by providers renewing approval, and by current providers seeking to render a waiver service they have not already been approved for.
Looking for the family-facing guide? Browse state waiver guides