North Dakota - Personal Emergency Response System — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

North Dakota Health and Human Services (HHS) funds Personal Emergency Response System (PERS) services through the ND Medicaid Waiver for Home and Community Based Services (0273.R06.00), requiring agencies to enroll as Qualified Service Providers (QSPs). Approval mandates demonstrating 24/7 monitoring capabilities and completing the QSP application packet before accessing the Health Enterprise MMIS portal.

Agencies must maintain UL-listed equipment and secure a QSP agency number from the HHS Aging Services Division. Out-of-state monitoring centers can participate if they meet North Dakota's telehealth and out-of-state provider attestation requirements, provided they maintain continuous response capabilities for individuals at risk of falls.

1. Service Definition and Scope

In North Dakota, the Personal Emergency Response System (PERS) is defined as an electronic device that enables individuals at high risk of institutionalization to secure help in an emergency. The system is connected to the person's phone and programmed to signal a response center once a portable "help" button is pressed.

The service includes the initial installation of the equipment, monthly rental, and the ongoing 24-hour monitoring service. It does not cover the cost of the telephone line itself or general home security systems.

• Target Population: Individuals living alone or who are alone for significant parts of the day and are at risk of falls.
• Equipment Standards: Devices must be Underwriters Laboratories (UL) listed or meet equivalent safety standards.
• Response Center: Must operate 24 hours a day, 7 days a week, 365 days a year.
• Service Components: Installation, monthly monitoring, and equipment maintenance/testing.
• Exclusions: General home security, fire alarms, and standard telephone service fees.

2. Regulatory and Oversight Agencies

North Dakota Health and Human Services (HHS) is the primary umbrella agency overseeing Medicaid and HCBS waivers. Within HHS, the Medical Services Division handles Medicaid enrollment, while the Aging Services Division manages the Qualified Service Provider (QSP) standards.

Providers must interact with both divisions to achieve full authorization to bill for PERS services under the HCBS waiver.

• North Dakota Health and Human Services (HHS): https://www.hhs.nd.gov
• HHS Medical Services Division: https://www.hhs.nd.gov/healthcare/medicaid
• HHS Aging Services Division: https://www.hhs.nd.gov/aging
• North Dakota Health Enterprise MMIS Portal: https://mmis.nd.gov/portals/wps/portal/EnterpriseHome

3. Gatekeeping Prerequisites: Who Can Even Apply

North Dakota does not require a Certificate of Need (CON) or a competitive Request for Proposals (RFP) to become a PERS provider. The state operates an open enrollment model for this service.

The mandatory structural precondition is obtaining Qualified Service Provider (QSP) Agency status from the HHS Aging Services Division. An applicant cannot enroll in the MMIS portal for HCBS waiver billing without first holding an approved QSP authorization.

• Certificate of Need: Not required for PERS providers in North Dakota.
• Network Status: Open enrollment; no closed networks or moratoria currently in effect.
• QSP Authorization: Required prerequisite before Medicaid MMIS enrollment.
• Business Registration: Must be registered and in good standing with the North Dakota Secretary of State.

4. Licensure and Certification Requirements

North Dakota does not issue a distinct "PERS License" through a health facilities board. Instead, the state relies on the Qualified Service Provider (QSP) certification process to vet agencies.

Providers must attest to meeting specific technical standards, including maintaining UL-listed equipment and having redundant power and communication systems at the monitoring center.

• State License: No specific facility license required; QSP certification serves as the operating authority.
• Equipment Certification: Devices must be UL-listed for home healthcare signaling equipment.
• Monitoring Center Standards: Must have backup power generators and redundant communication lines.
• Out-of-State Providers: Must submit the OOS Telehealth Attestation if operating the monitoring center outside North Dakota.

5. Medicaid Provider Enrollment

Once QSP status is granted, agencies must enroll through the North Dakota Health Enterprise MMIS portal. North Dakota operates primarily on a fee-for-service model for HCBS waivers.

Providers must complete the General Individual or Group Application requirements and submit all necessary documentation, including W-9s and EFT authorization forms, directly through the portal.

• Enrollment System: North Dakota Health Enterprise MMIS portal.
• Provider Type: Enrolled as an HCBS Waiver Provider / Qualified Service Provider.
• Application Fee: Subject to the federal Medicaid institutional application fee unless waived or paid to Medicare/another state.
• Revalidation: Required every 5 years per CMS guidelines.

6. Staffing, Training and Background Checks

While PERS is primarily an equipment-based service, the staff installing the equipment and the operators at the response center must meet state standards. Installers must be trained on the specific devices used.

All agency owners and managing employees must undergo background checks during the QSP and Medicaid enrollment processes to ensure no exclusions from federal healthcare programs.

• Background Checks: Required for all owners with 5% or more interest and managing employees.
• OIG Exclusion List: Monthly checks required for all staff and contractors.
• Installer Training: Must be documented by the agency showing competency with the specific UL-listed devices.
• Dispatcher Qualifications: Must be trained in emergency response protocols and triage.

7. Documentation, Policies and Records

PERS providers must maintain comprehensive records of all installations, monthly tests, and emergency activations. North Dakota HHS requires these records to be available for audit upon request.

Agencies must have written policies detailing their response protocols, equipment maintenance schedules, and procedures for handling false alarms or equipment failures.

• Client Records: Must include the date of installation, signed service agreement, and list of emergency contacts.
• Testing Logs: Monthly signal testing documentation must be retained.
• Incident Reports: Detailed logs of every emergency button press, including time, date, and outcome.
• Record Retention: Must keep all Medicaid-related records for a minimum of 6 years.

8. Billing, Rates and Claims

Billing for PERS in North Dakota is conducted through the Health Enterprise MMIS portal using standard HCPCS codes. Services are typically billed in two parts: a one-time installation fee and a recurring monthly monitoring fee.

Rates are established by the North Dakota Legislature and published in the HHS HCBS rate schedule. Prior authorization from the client's HCBS case manager is required before billing.

• Billing System: Health Enterprise MMIS portal.
• Installation Code: S5160 (Emergency response system; installation and testing).
• Monitoring Code: S5161 (Emergency response system; service fee, per month).
• Prior Authorization: Mandatory; must be included in the client's approved person-centered care plan.

9. Approval Sequence and Timeline

The approval process begins with the QSP application to the Aging Services Division. Once approved, the provider moves to the MMIS enrollment phase.

The entire sequence typically takes 60 to 90 days, depending on the completeness of the application and the volume of applications being processed by ND HHS.

• Step 1: Register business with the ND Secretary of State.
• Step 2: Submit QSP application to HHS Aging Services Division (30-45 days).
• Step 3: Submit Medicaid enrollment via Health Enterprise MMIS (30-45 days).
• Step 4: Receive Provider ID and begin accepting HCBS case manager authorizations.

10. Common Denials and Survey Findings

Applications are most frequently delayed or denied due to incomplete QSP packets or failure to properly complete the out-of-state provider attestations for remote monitoring centers.

During audits, the most common findings relate to missing documentation of monthly equipment tests or failure to maintain updated emergency contact lists for clients.

• Application Denial: Incomplete ownership disclosures or missing W-9 forms.
• Audit Finding: Lack of documented monthly signal tests.
• Audit Finding: Billing for months where the client was hospitalized or in a nursing facility.
• Audit Finding: Failure to report changes in agency ownership or monitoring center location to HHS.

11. Key Contacts and Resources

Providers should utilize the official North Dakota HHS portals and contact centers for the most current forms, rate schedules, and policy manuals.

The Customer Support Center and the Medical Services Division are the primary points of contact for enrollment and billing inquiries.

• ND HHS Provider Enrollment: https://www.hhs.nd.gov/healthcare/medicaid/provider/enrollment-information
• ND Medicaid Waivers Page: https://www.hhs.nd.gov/healthcare/medicaid/medicaid-waivers
• Health Enterprise MMIS Portal: https://mmis.nd.gov/portals/wps/portal/EnterpriseHome
• HHS Customer Support Center: [email protected]

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