Developmental Disabilities Waiver


Developmental Disability Waiver (DDW) recipients work with their DDW Case Manager (CM) to develop the Individual Service Plan (ISP) and budget. Molina Healthcare TPA is responsible for entering the budget into the Omnicaid system. A Prior Authorization (PA) number will be sent to the case management agency for the budget. All budgets for children and Jackson Class members are submitted to Molina Healthcare TPA on form MAD 046 or for non-Jackson adults on the DD Waiver Budget Excel worksheet with appropriate HIPAA-compliant codes.
 
  • DD Waiver: Molina Healthcare TPA also is responsible for reviewing outlier services, awake staffing, and changes to residential status, physical therapy/occupational therapy/speech-language pathology reviews using the TSPAR, behavioral supports consultation reviews using the BSCPAR, and adult nursing reviews using the ANSPAR. In addition, Molina reviews initial and annual level of care (LOC) packets submitted by the waiver CM. These services are measured against the DDW Service Standards and the documentation provided.

 

 

icon PDF Adult Nursing Services Prior Authorization Request (ANSPAR) Form

icon PDF Behavior Supports Consultation Prior Authorization Request (BSCPAR) Form

icon PDF Client Individual Assessment form

icon PDF DDSD PRIOR APPROVAL Form

icon PDF Individual Service Plan

icon PDF Intensive Medical Living Services Prior Auth Form 

icon PDF Therapy Service Prior Authorization Request Form 

 

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