Medicaid Provider Enrollment Overview
New York offers 5 Medicaid waiver programs for home care agencies. The state Medicaid program is administered by New York State Department of Health - Office of Health Insurance Programs. New York currently has a waitlist for new provider enrollment.
The average enrollment timeline is 180-365 days from initial application to receiving your first client. With high demand for home care services, New York represents an excellent opportunity for agencies looking to serve Medicaid clients.
New York Medicaid Waiver Programs
Home care agencies in New York can enroll in the following waiver programs. Each program serves different populations and has specific service requirements.
Managed Long Term Care (MLTC)
1115 WaiverManaged long-term care for nursing home eligible
Consumer Directed Personal Assistance Program (CDPAP)
State Plan WaiverConsumer-directed personal care
Nursing Home Transition and Diversion (NHTD) Waiver
1915(c) WaiverTransition from nursing homes
Traumatic Brain Injury (TBI) Waiver
1915(c) WaiverServices for individuals with TBI
Office for People with Developmental Disabilities (OPWDD) Waiver
1915(c) WaiverDD waiver services
New York Provider Requirements
To become a Medicaid provider in New York, your home care agency must meet the following requirements:
- New York business registration
- Licensed Home Care Services Agency (LHCSA) license from DOH
- Criminal background checks
- Professional liability insurance ($1M/$3M)
- Fidelity bond
- RN supervision
- Quality assurance program
Step-by-Step Enrollment Process
Follow these steps to enroll as a Medicaid waiver provider in New York:
Obtain LHCSA license from NY DOH
Apply for NPI
Complete eMedNY Provider Enrollment
Contract with MLTC plans
Complete DOH readiness review
Implement HHA Exchange or similar software