Contract Proposals

General Proposal Information for In-Home Services and Consumer Directed Services

Home and Community Based Services (HCBS) programs are intended to provide necessary assistance in meeting the unmet needs of seniors and adults with disabilities and enable the individuals to remain in the least restrictive environment.  HCBS consists of two separate programs, in-home services (agency model) and consumer directed services (consumer-directed model).  Separate proposals are required in order to be considered for the two programs.

The HCBS programs are operated by three state agencies:

Purpose of Proposal

In order to be considered for Medicaid enrollment with MMAC, a proposal must be submitted to MMAC for consideration for a participation agreement (“contract”).  A proposal is necessary for MMAC to evaluate the potential capability of business entities to provide HCBS in compliance with minimum regulatory program standards designed to ensure the health, safety and welfare of program participants.

Proposal Submission Requirements

All information listed in the appropriate Proposal for Contract must be submitted in order to be considered for a contract.  The following preliminary requirements must be met or the proposal will be denied.  The proposal must:

Once a proposal is submitted to MMAC, it becomes the property of MMAC and will not be returned to the applying provider.  Prior to mailing the proposal and/or any additional information requested, make a copy of the proposal for your records.

Hand-delivered proposals must be left with the receptionist.  No receipts will be provided unless a pre-prepared receipt is brought with the proposal.  The receptionist will then date stamp the receipt.

Proposal Review and Approval Process

Upon receipt of a proposal, MMAC Provider Contracts:

After submission of a proposal, it is approximately six months before provider numbers are issued and services can be provided to DSDS participants.  The amount of time required may be longer depending on the quality of the proposal submitted, the current workload of MMAC staff, and how quickly the applying provider responds to requests for additional information.

Provider Reimbursement Rates

Reimbursement rates are subject to and determined by the State Legislature on an annual basis.  MHD publishes information on the reimbursement rates each year. MHD’s Provider Bulletin Vol. 34, #2 dated July 27, 2011 contains the current maximum rate that will be paid for each service type provided. For example, the in-home services basic personal care current maximum rate is $4.24 per unit (or 15 minutes). While the rates listed in MHD’s Provider Bulletin are the maximum rates that will be paid, the provider’s usual and customary charge for each service provided should be billed.

Number of Participants

MMAC’s approval of the business entity’s proposal or subsequent Medicaid enrollment does not guarantee any particular volume of participants or that the services of a provider will be utilized by any state agency.  Participants have the right to choose the care option, care setting and provider to deliver his/her care.  When necessary to assist participants, questions will be answered by state agency staff, or their designee using information obtained through the proposal and enrollment processes and subsequent contacts by state agencies with the provider.

Additional Assistance

MMAC is not aware of any organizations available to assist with the completion of a proposal or any grants available to defray the cost of starting a business.

The Missouri Business Portal includes information for starting a business in Missouri.  The website address is http://www.business.mo.gov/.

Questions

Should you require additional information or have questions regarding the proposal process, you must review the Frequently Asked Questions (FAQs) prior to contacting MMAC. If you still have questions, you must contact MMAC Provider Contracts by e-mail at mmac.ihscontracts@dss.mo.gov. Submitting questions through e-mail will provide a written record of MMAC Provider Contracts’ response.  Your e-mail must include the name of your agency.

Consumer Directed Services Packet

General Information
Proposal for Contract
Assurances

In-Home Services Packet

General Information
Proposal for Contract
Assurances