Information for Potential Medicaid Contractors

Aging and Long Term Supports Administration - ALTSA administers Medicaid state plan and 1915(c) waivers, and the 1115 Medicaid Transformation Demonstration - MTD waiver that provide an array of long term services and supports to adults with unmet needs for assistance with activities of daily living due to functional impairments caused by age, physical disability or cognitive impairment as well as services and supports to their unpaid family caregivers.

ALTSA contracts with 13 Area Agencies on Aging - AAA to develop maintain and ensure a quality statewide Medicaid provider network to serve clients who are eligible for Medicaid long term services and supports.  All applicants must meet the minimum qualifications to provide services.  A Medicaid contract does not guarantee referrals. 

Eligible clients may choose to receive services from any qualified provider of a particular service.  Providers do not determine eligibility for services.  All state plan and 1915(c) waiver services are authorized by DSHS Home and Community Services and Area Agency on Aging staff.  MTD services are authorized by Area Agency on Aging staff.  Providers must have adequate cash flow to provide services in advance of reimbursement.   

Service authorizations and payment for claims are completed through the Health Care Authority’s ProviderOne payment system.  Applicants who receive a Medicaid contract will be mailed a ProviderOne Enrollment Packet from the Health Care Authority.  Additional training and resources for ProviderOne can be found at training.  DSHS determines Home and Community Services Medicaid rates, which are posted here.

Application materials for a Home and Community Services Medicaid contract are submitted directly to the Area Agency on Aging.  Contract templates provided in the links below are examples that are used for most businesses structures.  Additional templates are available that may be more appropriate for some applicants (e.g., county governments, tribal nations, quasi-governments).  Applicants who receive a contract will be monitored by the Area Agency on Aging. 

Medicaid Services are as follows.  Click on the link to get to the Provider Application Form: 

Steps to apply: 

  1. Click on the appropriate Medicaid Service listed above and follow the instructions specified on the Provider Application Form.   
  2. Gather appropriate documentation to show you meet qualifications to provide services under the contract. 
  3. If you are interested in providing one of the following services you may need an National Provider Identifier - NPI and a Core Provider Agreement - CPA
    1. Behavior support providers, including:
      1. MH  Agency
      2. Counselor
      3. Marriage and Family Therapist
      4. Psychologist
      5. Social Worker
      6. Social Worker, Clinical
      7. Chemical Dependency Counselor
    2. Certified Dietician/Nutritionist
    3. Occupational Therapist
    4. Physical Therapist
    5. Pharmacist
    6. Nurses
      1. Registered Nurse, Agency
      2. Registered Nurse, Individual
      3. Licensed Practical Nurse
    7. Adult Day Health Provider
    8. Home Health Agency
    9. Speech/Hearing/Communication Pathologist
    10. Durable Medical Equipment
  4. After reviewing specific Medicaid Service requirements and instructions, submit all required documents to the appropriate Area Agency on Aging Intake Contact.  If interested in contracting with more than one AAA, all documents must be submitted to each AAA Contact. 

Some Provider Application Forms are still under development.  If there is no link to the Medicaid Service for which you wish to apply, please complete the contractor intake form and submit to the Area Agency on Aging Intake Contact, who will provide you with the next steps.   

ALTSA directly contracts for the Medicaid services listed below.  Therefore, do not contact the Area Agency on Aging for these contracts.  Instead, see the links referenced below if you are seeking one of the following contracts: