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The purpose of this provider manual update memorandum is to inform providers of CCC Plus Waiver services of updates to the CCC Plus Waiver Provider Manual and forms. 

In addition to changes to conform with regulations and recent bulletins on LRI policies and Services Facilitators requirements, the following substantive updates have been made: 

Chapter II of the CCC Plus Waiver Provider Manual:

1. Addition of sections “Signatures by an Advance Practice Registered Nurse or Nurse Practitioner” and “Person-Centeredness”;

2. Private Duty Nursing licensure requirements that had been removed in error; and

3. Clarifications for Criminal Background Checks and Agency-Directed Personal Care Aide training requirements.

Chapter IV of the CCC Plus Waiver Provider Manual:

1. Consumer-Directed Requirements: Using the DMAS-95 Addendum or DMAS-95B for all new Employers of Record; justification for 30 or 60 day routine visits; Reassessment Visit activities; Management Training documentation; and describing involuntary disenrollment reasons; 

2. Requiring the personal care agency/Services Facilitator to document the time per task on the Plan of Care for personal care;

3. PERS: Prohibition on billing for member self-installation and annual documentation of the DMAS-100A;

4. Additional clarifications on developing the Plan of Care annually; critical incidents; Start of Care date (when the nurse/Services Facilitator performs the initial assessment for CCC Plus Waiver services before any aide starts services); who can and cannot sign certain forms; and not requiring a composite score on the respite Plan of Care.

The Extraordinary Care Guide is being added to the CCC Plus Waiver Provider Manual as Appendix E.

The DMAS-97A/B Plan of Care form has been updated with the following:

1. Boxes to check if the Plan of Care is for personal care/assistance, respite, or LRI personal care/assistance;

2. More room and details to explain the required backup plan; and

3. Addition of questions and instructions for LRI Plans of Care.

The DMAS-99, Community-Based Care Member Assessment, has been updated with the following:

1. Removal of the Start of Care Date field;

2. Addition of questions related to the member’s care and support system, including primary care visits and whether the member has a LRI as an aide/attendant; and 

3. Additional questions on the frequency of routine visits and critical incident reporting. 

It is required that providers adopt the new versions of the DMAS-97A/B and DMAS-99 no later than October 1, 2026. Use of older versions of these forms after this date will result in denial of service authorization requests.

The provider manual and forms can be found on the Medicaid Enterprise System (MES) website.

To avoid disruption to claims payment through FFS and the MCOs providers must periodically check the DMAS provider portal, also known as the Provider Services Solution (PRSS), to ensure that the provider's enrollment, contact information, and license information is up to date, for all of the provider's respective service locations. Under federal rules, MCOs and DMAS are prohibited from paying claims to network providers who are not enrolled in PRSS. Additional information is provided on the MCO Provider Network Resources webpage and includes links to resources, tutorials and contact information to reach Gainwell with any provider enrollment or revalidation related questions.  Dental providers should continue to enroll directly through the DMAS Dental Benefits Administrator, DentaQuest.