Georgia - I/DD Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) and the Department of Community Health (DCH) jointly approve providers for the New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP). Prospective agencies must submit a Letter of Intent (LOI) exclusively during designated open enrollment periods managed by the Georgia Collaborative ASO before any application is accepted.

Approved providers deliver a continuum of home and community-based services, ranging from community residential alternative (CRA) host homes to supported employment. The dual-enrollment process requires clearing DBHDD programmatic certification, including regional field office site visits, followed by DCH Medicaid fee-for-service enrollment through the GAMMIS portal.

1. Service Definition and Scope

Georgia's I/DD service array is funded primarily through the NOW and COMP waiver programs. These waivers provide home and community-based services for individuals with intellectual and developmental disabilities.

Services range from habilitation and supported employment to residential supports like host homes. All waiver participant services require prior approval (PA) by DBHDD before delivery.

• NOW Waiver: New Options Waiver Program offering community-based supports.
• COMP Waiver: Comprehensive Supports Waiver Program for individuals needing intensive out-of-home residential supports.
• Operating Agency: DBHDD Division of Developmental Disabilities manages day-to-day operations and level of care determinations.
• Medicaid Agency: DCH oversees the waiver and handles reimbursement.
• Service Authorization: All claims pay according to the waiver participant’s approved Prior Approval (PA) entered into the Medicaid Management Information System.

2. Regulatory and Oversight Agencies

Oversight of NOW and COMP waiver providers is split between the operating agency (DBHDD) and the state Medicaid agency (DCH). DBHDD handles programmatic certification and site visits, while DCH manages the final Medicaid enrollment and billing.

DBHDD utilizes a third-party contractor, the Georgia Collaborative ASO, to manage the front-end provider enrollment forums, LOI submissions, and initial application processing.

• Operating Agency: Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) at https://dbhdd.georgia.gov/
• Medicaid Agency: Georgia Department of Community Health (DCH) at https://dch.georgia.gov/
• Enrollment Contractor: Georgia Collaborative ASO at https://www.georgiacollaborative.com/
• Medicaid Portal: Georgia Medicaid Management Information System (GAMMIS) at https://www.mmis.georgia.gov/

3. Gatekeeping Prerequisites: Who Can Even Apply

Georgia strictly controls entry into the NOW and COMP provider network through scheduled open enrollment periods. Providers cannot simply submit an application at any time; they must wait for an open window to submit a Letter of Intent (LOI).

Before submitting the LOI, prospective providers must register for and attend a mandatory New Provider Enrollment Forum presented by the Georgia Collaborative ASO.

• Mandatory Training: Registration and attendance at a New Provider Enrollment Forum via the Georgia Collaborative ASO.
• Open Enrollment Window: Applications are only accepted following an approved LOI submitted during a specific open enrollment period.
• Letter of Intent (LOI): Submission of the I/DD Agency Provider LOI or I/DD Individual Provider LOI via the Georgia Collaborative ASO portal.
• Invitation to Apply: Only applicants with an approved LOI receive a formal invitation to submit the DBHDD New Provider Application.

4. Licensure and Certification Requirements

Georgia does not issue a single "I/DD license." Instead, providers must meet DBHDD "Core Requirements for Providers" and obtain specific facility licenses from DCH if operating residential or day center settings.

Certification is a review process conducted by DBHDD focusing on these core standards. A site visit by the appropriate Regional Field Office is required to review the organization and its programs before DBHDD approval is granted.

• DBHDD Certification: Review process focusing on standards found in the Core Requirements for Providers.
• Site Visit: Unannounced or scheduled inspection conducted by the DBHDD Regional Field Office.
• Business License: Georgia business license as required by the local city or county jurisdiction.
• Surety Bond: Fiscal Intermediary Agencies require a surety bond equal to or greater than managed accounts, minimum $250,000.

5. Medicaid Provider Enrollment

After DBHDD approves the programmatic application and site visit, providers must complete the DCH online application via the GAMMIS portal. This is a fee-for-service Medicaid enrollment.

The GAMMIS Enrollment Wizard guides applicants through a 12-step process, generating an Application Tracking Number (ATN) used to monitor status. Georgia requires re-enrollment every three years.

• Enrollment Portal: GAMMIS Enrollment Wizard at mmis.georgia.gov.
• Application Fee: $750 fee for institutional providers, per 42 CFR 455.460.
• Tracking System: Application Tracking Number (ATN) generated upon submission for status checks.
• Risk Screening: Moderate categorical risk screening for behavioral health and I/DD agencies, including site visits.
• Re-enrollment Cycle: Georgia DCH policy requires re-enrollment every 3 years.

6. Staffing, Training and Background Checks

All NOW and COMP providers must ensure staff meet the specific qualifications outlined in the DBHDD service definitions. This includes rigorous background screening.

DBHDD requires annual verification of background checks for all providers to ensure ongoing compliance and safety for waiver participants.

• Background Checks: Criminal history background checks are required and must be paid for by the provider.
• Annual Verification: All providers receive annual verification of compliance through DBHDD.
• Orientation: Approved providers must complete DBHDD New Provider Orientation.
• Exclusion Checks: DCH runs OIG LEIE exclusion checks and SAM.gov sanctions checks during enrollment.

7. Documentation, Policies and Records

Providers must submit extensive documentation during both the DBHDD and DCH application phases. Discrepancies between state records and application data will cause immediate rejections.

Agencies must maintain policies aligning with DBHDD standards, including host home matching and monitoring policies if providing Community Residential Alternative (CRA) services.

• Ownership Disclosure: Required under 42 CFR 455.104, listing anyone with 5 percent or more ownership interest.
• Tax Documentation: W-9 form with a Tax Identification Number matching IRS records exactly.
• NPI Verification: NPI Type 2 for organizations, verified at the NPPES public registry.
• Host Home Policy: Agencies must follow DBHDD policy 02-704 for enrolling and monitoring Host Home/Life-Sharing Sites.

8. Billing, Rates and Claims

Reimbursement for NOW and COMP services is managed by DCH through the GAMMIS system. Providers cannot bill until they receive their Medicaid Provider Number (MPN).

All claims must match the Prior Approval (PA) entered into the MMIS by DBHDD. Services billed without a matching PA will be denied.

• Billing System: Claims are submitted through the GAMMIS portal.
• Prior Approval (PA): All waiver participant services require PA by DBHDD entered into MMIS.
• Provider Number: DCH assigns the Medicaid Provider Number (MPN) upon final approval.
• Claim Adjudication: All claims pay strictly according to what is on the waiver participant’s approved PA.

9. Approval Sequence and Timeline

The approval sequence is strictly phased. Phase 1 involves the forum, LOI, and invitation. Phase 2 involves the DBHDD application, site visit, and DCH GAMMIS application.

If the DCH application is denied at the final stage, the provider is locked out and must wait one full year before restarting at Phase 1 during a new open enrollment period.

• Phase 1 Step 1: Register and attend New Provider Enrollment Forum.
• Phase 1 Step 2: Submit LOI during open enrollment window.
• Phase 2 Step 1: Submit DBHDD New Provider Application upon invitation.
• Phase 2 Step 2: Regional Field Office conducts site visit.
• Phase 2 Step 3: Complete DCH online application via GAMMIS.
• Denial Penalty: 1-year waiting period required before reapplying if DCH denies the application.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to administrative mismatches or failure to track the application properly through the GAMMIS portal.

Post-enrollment, DBHDD revokes eligibility for providers who fail to maintain required licensure or lapse in conducting mandatory background checks.

• ATN Loss: Failure to record the Application Tracking Number (ATN) prevents status checks and delays corrections.
• Taxonomy Mismatch: Provider taxonomy code on GAMMIS failing to match the specialty designation.
• Credential Inconsistencies: License name, number, or expiration date not exactly matching Georgia state records.
• Revocation Cause: Failure to maintain licensure, comply with service expectations, or conduct annual background checks.

11. Key Contacts and Resources

Providers must interact with multiple entities throughout the lifecycle of their enrollment. The Georgia Collaborative ASO handles the front end, DBHDD handles programmatic oversight, and Gainwell Technologies manages the GAMMIS portal for DCH.

Applicants should retain their ATN and use the specific portals for status updates rather than relying solely on phone support.

• DBHDD Main Site: https://dbhdd.georgia.gov/
• Georgia Collaborative ASO (Enrollment): https://www.georgiacollaborative.com/providers/enrollment/
• GAMMIS Portal: https://www.mmis.georgia.gov/
• Provider Enrollment Unit (Gainwell): Call 1-800-766-4456 for GAMMIS application status using the ATN.

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