New Provider and Onboarding Resources

To become a provider agency in NH, you need to initially work on obtaining the ability to bill by becoming a Medicaid-Enrolled Provider. In addition to that, you need to register your business name with the NH Secretary of State. An application for licensing and certification of the new facility is also required, please visit Health Administration Facilities to begin the certification process.

Please review the He-M rules pertinent to the type of services you plan to offer under Supplemental Information.

Once that is done, you would then work with area agencies to advertise your desire to provide supports for individuals.

Becoming a Medicaid-Enrolled Provider in New Hampshire

Under federal regulations from the Centers for Medicare and Medicaid Services (CMS), providers must have the option to bill for services directly through the State’s Medicaid Management Information System (MMIS) or use a third-party biller.

All providers providing services, including all Area Agencies, for individuals under the Developmental Disabilities (DD) Waiver, In-Home Supports (IHS) Waiver, and/or Acquired Brain Disorder (ABD) Waiver must be a Medicaid enrolled provider, whether they intend to bill directly or not. 

• Visit NH’s MMIS Health Enterprise Portal to submit an application, which also includes instructions based on what type of provider enrollment you are looking for. This is supported by Provider Relations, if you need assistance or guidance on where to obtain certain information that is required to complete the application.
• Entities interested in being a trading partner will also need to go through the direct-bill enrollment process.

Screening Process

New Providers will need to complete a screening through the Bureau of Developmental Services (BDS). This process is outlined in He-M 504 - "Provider and Provider Agency Operations". 

Each provider applicant shall participate in a department screening upon enrollment and re-enrollment to review the following:

1. Mission and vision statements, as applicable; 
2. Training practices, such as but not limited to, requirements per specific position, purchased training platforms, and continuing education hours requirements;
3. Service-specific competencies, as related to developmental services defined in chapter He-M 500;
4. Three references that illustrate the provider applicant’s ability to meet their service obligations in accordance with their mission and vision statement; 
5. Financial indicators of fiscal integrity, including but not limited to; a. Financial statements identifying current portion of long-term debt payments (principal and interest); and b. A measure of total current assets available to cover the cost of current liabilities; 
6. Liability protections; 
7. Policies and practices regarding restraint and seclusion; 
8. Attestation that criminal background and appropriate registry checks were completed pursuant to He-M 504.03 (g)-(h);
9. Attestation that office of inspector general checks were completed in accordance with HeM 504.03(n).

Please contact BDS to complete the screening. 

Settings Rule

To help ensure services integrated in community based settings meet the Final Settings Rule, the New Provider Self Assessment should be completed and submitted to BDS where the Waiver Transition Team members will meet to discuss and determine next steps which may include in-person Final Settings Rule Site visits. Please visit Settings Rule for the Statewide Transition Plan for additional information.

After you have completed and submitted the application for provider enrollment, you may reach out for status updates at: