NHTD Medicaid Waiver Program

For Providers

The Nursing Home Transition and Diversion (NHTD) program includes many types of providers and professionals who help applicants/participants with the application process, coordinate services for participants, and provide direct and indirect services to participants. This page includes information for these professionals.

All NHTD Waiver Service Providers are approved Medicaid providers. However, not all Medicaid providers are automatically approved to be NHTD Waiver Service Providers. All NHTD Waiver Service Providers, including those already approved to provide services under the Medicaid State Plan or another Medicaid waiver, are required to also be approved as an NHTD waiver service provider.

NHTD Waiver Service Providers must be located in and able to provide services in New York State. NHTD Waiver Service Providers must meet all licensure and other qualifications of the service(s) they are applying for as specified in Appendix C of the approved 1915(c) waiver application.

NHTD Waiver Service Providers are responsible for knowing, understanding and implementing the waiver in accordance with the established policies and procedures. Waiver Service Providers are also responsible for knowing, understanding and implementing the waiver in accordance to required billing and documentation standards established by the Centers for Medicare and Medicaid Services (CMS), NYSDOH, eMedNY, and monitored by the Office of the Medicaid Inspector General (OMIG).

Each RRDC will hold at least eight (8) provider meetings each year. Meetings may be held in person or through indirect means such as webinars and teleconferences. This will be at the discretion of the RRDC. Approved NHTD Waiver Service Providers must attend at least eight (8) scheduled provider meetings in each region in which the NHTD Waiver Service Provider is approved. The following providers are exempt from attending the mandatory provider meetings unless the RRDC deems that the meeting is relevant to the provider: Assistive Technology (AT); Community Transitional Services (CTS); Moving Assistance; Congregate and Home Delivered Meals; Environmental/Vehicle Modifications; Home Visits by Medical Personnel; and Respiratory Therapy.

NOTE: If an NHTD Waiver Service Provider staff is employed at more than one NHTD Waiver Service Provider agency, they may only represent one (1) agency when attending provider meetings.

NHTD Waiver Service Providers may request approval for any number of waiver services for which they qualify in more than one region through the Regional Resource Development Center (RRDC).

RRDCs are grant-funded contractors of the New York State Department of Health that manage the application, participation, and renewal processes of the NHTD program. Any interested provider must contact the appropriate RRDC region(s) to start the application process for the NHTD Waiver. The RRDC will complete a Waiver Service Provider Interview and the program application packet and then submit to NYSDOH for review and approval.

Professionals/organizations interested in becoming an NHTD Waiver Service Provider must submit the following documents to the RRDC for review and approval in order to complete the application process:

  1. Letter of Intent signed and dated on agency letterhead listing the region(s), service(s) and counties they are applying for and a brief explanation/history of the agency;
  2. Copy of FEIN letter (agency tax number);
  3. Copy of LHCSA License, if seeking to provide Home and Community Support Services (HCSS) or Respite;
    An HCSS provider may only offer services in the counties identified on their LHCSA license
  4. Employee Verification of Qualifications form for each service the provider is seeking to offer. Each service must be represented by a different qualified staff person;
  5. Signed four-page Provider Agreement; and
  6. Provider specific Policies and Procedures which designate how the provider will manage the provision of waiver services and meet compliance with program standards. This information will include the curriculum for staff training.

Upon the provider´s signature on the Provider Agreement form, the Waiver Service Provider must report any subsequent change(s) in status to NYSDOH and its contractors (RRDC). These changes may include: change of ownership and control; change of address; and change of provider contact information. The provider is responsible for verifying that the individual(s) maintains the needed license, registration or certification throughout the period of time they provide waiver services and are employed by the provider.

An eMedNY application will need to be completed to obtain a Medicaid MMIS ID (Provider ID) and payment to eMedNY. The eMedNY application and additional forms list can be found here.

Note: Boxes to check are "Billing Provider"; "Category of Service" is 0263; and "New Enrollment". The original application and payment should be sent directly to eMedNY at the address listed on the application with a COPY of all eMedNY documents given to the RRDC.

Once the eMedNY application is processed and a MMIS Provider ID is assigned, DOH reviews the RRDC Interview Application packet. If all qualifications are met, DOH submits a rates transmittal for the approved service(s) rate code(s) and rate(s) to be uploaded into the eMedNY system for billing purposes. A final approval letter will be sent to the RRDC and provider which includes the effective date of approval and the service(s) that are approved. At this time, the RRDC may include the provider on their active provider list to accept new cases.

  • Nursing Home Transition & Diversion (NHTD) Waiver Services Approved Rates - (PDF)

Historical Rates