CASE MANAGEMENT SERVICES PROVIDER IN MARYLAND

COORDINATING QUALITY CARE, ADVOCACY, AND PERSON-CENTERED SUPPORTS FOR INDIVIDUALS WITH DISABILITIES AND THEIR FAMILIES

Case Management Services in Maryland play a vital role in ensuring individuals with intellectual and developmental disabilities receive coordinated, person-centered, and outcome-driven services. While most traditional case management is delivered through Coordination of Community Services (CCS) agencies authorized by the Maryland Developmental Disabilities Administration (DDA), Medicaid also funds various forms of Targeted Case Management (TCM) and Supports Planning Services under programs like Community First Choice (CFC) and Community Options Waiver.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)

Role: Oversees Medicaid and waiver program policy for case management across all populations

Agency: Developmental Disabilities Administration (DDA)

Role: Authorizes and regulates CCS agencies and monitors case management standards under DDA waivers

Agency: Office of Long-Term Services and Supports (LTSS Maryland)

Role: Hosts provider portal for case documentation, service planning, and billing

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight of case management and care coordination under Medicaid HCBS Waivers

2. CASE MANAGEMENT SERVICE OVERVIEW

Case Management services help individuals:

• Navigate DDA or Medicaid waiver eligibility and enrollment

• Develop, update, and implement Person-Centered Plans (PCPs) or Individual Plans (IPs)

• Link to medical, behavioral, and social services

• Advocate for needed supports in employment, education, housing, and health care

• Monitor quality of care and adjust services as needed

• Prevent institutionalization by promoting natural and community supports

There are two major categories:

• Coordination of Community Services (CCS): For individuals enrolled in DDA Waivers

• Supports Planning/Case Management (LTSS): For Community First Choice and Community Options enrollees

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your organization with the Maryland Department of Assessments and Taxation (SDAT)

• Obtain EIN and Type 2 NPI

• Apply as a CCS Agency through the DDA Coordination Services Provider Application

• OR apply through Medicaid’s ePREP system to deliver Supports Planning under CFC or Community Options

• Maintain professional liability insurance and HIPAA-compliant documentation systems

• Employ qualified Case Managers, also known as Coordinators of Community Services (CCS) or Supports Planners

Note: The DDA may issue Requests for Proposals (RFPs) for new CCS agencies based on regional demand.

4. ENROLLMENT & SERVICE AUTHORIZATION PROCESS

Step 1: Prepare Service Design and Program Structure

• Define case management philosophy and team responsibilities

• Create a system for tracking plans, contacts, progress, and outcomes

Step 2: Apply to Become a CCS Agency (DDA)

• Submit provider application with organization chart, policy manual, staff qualifications, and supervision model

• Be prepared for compliance review and background check requirements

Step 3: Enroll as a Supports Planning Agency (CFC/Community Options)

• Apply through the ePREP portal

• Meet staffing, credentialing, and conflict-of-interest requirements

Step 4: Start Service Delivery

• Accept referrals from DDA, hospitals, or the local Area Agencies on Aging

• Document all interactions and maintain person-centered planning timelines

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC paperwork

• IRS EIN and NPI confirmation

• DDA or Medicaid provider approval

• Policy & procedure manual including:

  • Intake and referral forms

  • Person-Centered Planning (PCP) templates

  • Service coordination logs and contact sheets

  • Critical incident reporting procedures

  • Confidentiality and HIPAA policies

  • Crisis response and de-escalation policies

  • Supervision and quality assurance systems

  • Staff training documentation and annual evaluations

6. STAFFING REQUIREMENTS

Role: Case Manager / Coordinator of Community Services (CCS) / Supports Planner

Requirements:

• Bachelor’s degree in human services, social work, psychology, or a related field

• At least one year of experience with individuals with disabilities or vulnerable populations

• Criminal background check, CPR/First Aid (recommended), and HIPAA training

• Strong documentation, advocacy, and interpersonal communication skills

Role: Clinical Supervisor or Program Director

Requirements: Master’s degree or extensive case management experience, responsible for oversight and compliance

Training Requirements:

• DDA Orientation and PCP development

• Person-Centered Thinking and Planning Tools

• HCBS rights and service documentation

• Crisis management and mandated reporting

• Annual professional development and ethics review

7. MEDICAID WAIVER SERVICES

Case Management is reimbursed under:

• DDA Waivers (Community Pathways, Community Supports, Family Supports): Through the CCS model

• Community First Choice (CFC): Through Supports Planning Agencies

• Community Options Waiver: Case management for individuals in the community

• Increased Community Services (ICS): For individuals transitioning from institutions

• 1915(i) State Plan Option: (if applicable for behavioral or physical disability populations)

Authorized functions include:

• Intake and needs assessment

• Person-Centered Plan development and review

• Service referral and linkage

• Monitoring and follow-up

• Advocacy and crisis intervention

• Documentation and Medicaid-compliant billing

8. TIMELINE TO LAUNCH

Phase: Business Registration

Timeline: 1–2 weeks

Phase: Application to DDA or Medicaid via ePREP

Timeline: 4–8 weeks

Phase: Staff Hiring and Training

Timeline: 2–3 weeks

Phase: Referral Connections and Service Initiation

Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)

Website: https://dda.health.maryland.gov

Email: dda.providerapps@maryland.gov

Maryland Medicaid Provider Enrollment (ePREP)

Website: https://eprep.health.maryland.gov

LTSS Maryland – Medicaid Case Management Tracking

Website: https://ltss.health.maryland.gov

Maryland Department of Aging (Supports Planning Resources)

Website: https://aging.maryland.gov

Maryland Department of Assessments and Taxation (SDAT)

Website: https://egov.maryland.gov/BusinessExpress

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND CASE MANAGEMENT PROVIDER

We help compassionate professionals and mission-aligned organizations establish DDA-approved or Medicaid-enrolled Case Management services rooted in advocacy, accessibility, and high-quality coordination.

Scope of Work:

• Business registration (LLC, EIN, NPI)

• DDA CCS application or Medicaid Supports Planning enrollment

• Policy & procedure manual for case documentation, referral flow, and plan updates

• Staff credentialing trackers and person-centered planning templates

• HIPAA-compliant communication tools and recordkeeping systems

• Website and professional intake packet design

• Referral networking with hospitals, CCS offices, and waiver providers

• Training schedules and audit preparation tools

Continue To Our Client Portal To Get Started

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