Lead Agency

Role: Arkansas Department of Human Services (DHS) holds ultimate authority over the state's Medicaid programs.

Operating Agency

Role: Division of Developmental Disabilities Services (DDS) manages the CES Waiver policy and program rules.

Licensing and Certification

Role: Division of Provider Services and Quality Assurance (DPSQA) processes applications and issues the required CES Waiver Provider Certification.

Medicaid Authority

Role: Division of Medical Services (DMS) oversees the Medicaid state plan and the MMIS provider enrollment portal.

Managed Care Entities

Role: PASSEs (e.g., Arkansas Total Care, CareSource PASSE, Empower Healthcare Solutions, Summit Community Care) manage care, authorize services, and pay claims.

3. GATEKEEPING PREREQUISITES: WHO CAN EVEN APPLY 

Arkansas does not require a Certificate of Need (CON) for HCBS prevocational services, but it utilizes a strict managed care gatekeeping model. A provider cannot operate as a standalone fee-for-service entity for the CES Waiver.

Before investing in the certification process, applicants must understand that access to clients is entirely controlled by the PASSEs. If a PASSE determines its network is adequate for prevocational services in a specific county, it may refuse to contract with a new provider, effectively blocking market entry.

• Managed Care Contracting: Must secure a network contract with at least one PASSE to receive client referrals and payment; Medicaid enrollment alone yields no revenue.
• Business Registration: Must be registered and in good standing with the Arkansas Secretary of State to conduct business in the state.
• Physical Location: Must maintain a physical operating location within Arkansas or within 50 miles of the state border to serve Arkansas Medicaid beneficiaries.
• Financial Solvency: Must provide proof of financial backing during the DPSQA certification process, such as a line of credit or CPA-audited financial statements, proving the ability to operate without immediate Medicaid revenue.

4. LICENSURE AND CERTIFICATION REQUIREMENTS 

Arkansas does not issue a standalone "Prevocational Services" license. Instead, agencies must apply for and obtain a CES Waiver Provider Certification from DPSQA. Prevocational services are approved as a specific service line under this umbrella certification.

The certification process requires a comprehensive review of the agency's operational policies, financial health, and compliance with federal HCBS settings regulations. Providers must submit their application through the DPSQA online portal.

• Certification Type: CES Waiver Provider Certification issued by the Division of Provider Services and Quality Assurance (DPSQA).
• Application Portal: Applications must be submitted electronically via the DPSQA Community Services Licensure and Certification portal.
• Policy Manual: Applicants must submit a comprehensive agency policy and procedure manual that aligns exactly with DDS Certification Standards.
• HCBS Settings Compliance: Must submit documentation and pass a review proving the service setting complies with the CMS HCBS Settings Final Rule.
• Provider Orientation: New providers are required to attend a mandatory DDS Provider Orientation session before final certification is granted.

5. MEDICAID PROVIDER ENROLLMENT

After obtaining DPSQA certification, the agency must enroll as an Arkansas Medicaid provider using the MMIS Health Care Provider Portal managed by Gainwell Technologies. Initial applications must be submitted electronically.

Arkansas Medicaid strictly enforces data matching. The exact legal name and tax identification number on the application must perfectly match the IRS W-9, the DPSQA certification, and the bank account information.

• Enrollment Portal: Arkansas MMIS Health Care Provider Portal.
• Provider Type: Enroll as Provider Type 95 (Certified Waiver Provider) with the applicable CES Waiver specialty.
• Application Fee: Must pay the federal Medicaid/Medicare application fee (approximately $709) via the Arkansas.gov payment portal, unless proof of payment to Medicare or another state's Medicaid program is provided.
• Required Form: W-9 form completed with the group's exact name and Tax ID (FEIN).
• Required Form: Electronic Funds Transfer (EFT) Authorization form accompanied by a voided check or a signed bank letter (deposit slips are not accepted).
• Data Matching: License name, license number, and expiration date entered in the portal must exactly match the DPSQA certification records.

6. STAFFING, TRAINING AND BACKGROUND CHECKS

Direct Support Professionals (DSPs) delivering prevocational services must meet strict qualifications set by DDS. Agencies are responsible for maintaining comprehensive personnel files that prove compliance with all background check and training mandates.

Background checks in Arkansas are multi-layered, requiring clearance from state police, federal databases, and specific state abuse registries before a staff member can provide unsupervised care.

• Minimum Age: Direct care staff must be at least 18 years of age.
• Education Requirement: Staff must possess a high school diploma or GED.
• Criminal Background Check: Mandatory fingerprint-based Arkansas State Police and FBI criminal background checks.
• Registry Checks: Must clear the Arkansas Child Maltreatment Central Registry and the Adult Abuse Registry.
• Initial Training: Must complete DDS-mandated training, including CPR, First Aid, and abuse/neglect reporting, prior to providing unsupervised services.
• Ongoing Training: Staff must complete a minimum of 12 hours of continuing education annually.

7. DOCUMENTATION, POLICIES AND RECORDS

Providers must maintain rigorous documentation to satisfy DPSQA certification standards, Medicaid program integrity audits, and PASSE quality reviews. Documentation must clearly link the daily activities to the goals outlined in the beneficiary's care plan.

Failure to maintain accurate, contemporaneous service logs is a primary cause for recoupment of funds during state or PASSE audits.

• Service Plan: Must maintain a current copy of the beneficiary's Person-Centered Service Plan (PCSP) developed by the PASSE Care Coordinator.
• Daily Service Logs: Must keep daily notes detailing the date of service, exact start and stop times, specific activities performed, and progress toward PCSP employment goals.
• Incident Reporting: Must maintain and follow policies for reporting critical incidents to the DHS Incident Reporting Information System (IRIS) within required timeframes.
• Record Retention: All Medicaid and service records must be retained for a minimum of five (5) years from the date of service or until all audit questions are resolved.
• Conflict-Free Policy: Must maintain a written policy ensuring conflict-free service delivery, separating case management from direct service provision.

8. BILLING, RATES AND CLAIMS

Prevocational services under the CES Waiver are not billed directly to Arkansas Medicaid (DMS). Instead, providers submit claims to the specific PASSE in which the beneficiary is enrolled.

Rates and billing increments are generally standardized across the PASSEs based on the state's fee schedule, but providers must adhere to the specific claims submission guidelines and clearinghouse requirements of each individual PASSE.

• Payer: Claims are submitted directly to the beneficiary's assigned PASSE (Arkansas Total Care, CareSource, Empower, or Summit).
• Billing Codes: Typically billed using HCPCS code T2015 (Habilitation, prevocational, waiver), though modifiers may be required by the PASSE.
• Prior Authorization: 100% of prevocational services require prior authorization from the PASSE, strictly matching the units approved in the PCSP.
• Unit of Service: Billed in 15-minute increments or as a per diem, depending on the specific authorization and PASSE contract terms.
• Timely Filing: Claims must generally be filed within 365 days of the date of service, though providers must verify if their specific PASSE contract stipulates a shorter window (e.g., 90 or 180 days).

9. APPROVAL SEQUENCE AND TIMELINE

Becoming a fully operational prevocational services provider in Arkansas is a lengthy, sequential process. Steps cannot be completed concurrently; certification must precede Medicaid enrollment, which must precede PASSE contracting.

Providers should plan for a minimum of 6 to 9 months of administrative processing before they can bill their first claim.

Step 1: Submit the CES Waiver Provider Certification application to DPSQA (Review takes up to 90 days).

Step 2: Receive provisional certification and complete the mandatory DDS Provider Orientation.

Step 3: Submit the Arkansas Medicaid Enrollment application via the MMIS Portal (Processing takes 30-60 days).

Step 4: Apply for credentialing and contracting with the PASSEs (Takes 90-120 days per PASSE).

Step 5: Receive PASSE network effective date, accept client referrals, and begin delivering authorized services.

10. COMMON DENIALS AND SURVEY FINDINGS

Applications are frequently delayed or denied at the MMIS enrollment stage due to simple administrative errors, particularly data mismatches. Arkansas Medicaid's automated systems will reject applications where names or tax IDs do not align perfectly.

During DPSQA surveys, providers often face citations for failing to treat prevocational services as time-limited, effectively running them as permanent day habilitation programs without documenting progress toward competitive employment.

• Application Denial: Name mismatches between the W-9, IRS records, and the DPSQA certification document.
• Application Denial: Missing required attachments on the MMIS portal, such as the EFT authorization form or a voided check.
• Survey Finding: Treating prevocational services as permanent day care; failing to document measurable progress toward competitive integrated employment.
• Survey Finding: Incomplete personnel files, specifically missing or expired background checks and abuse registry clearances.
• Survey Finding: Service logs lacking specific start and stop times, or notes that do not align with the goals authorized in the PCSP.

11. KEY CONTACTS AND RESOURCES

Providers must maintain contact with multiple state divisions and private managed care entities. The DHS website and the MMIS portal are the primary hubs for policy updates and enrollment actions.

For contracting and claims issues, providers must bypass state agencies and contact the Provider Relations department of the specific PASSE.

• DPSQA Community Services: Handles licensure and CES Waiver certification (Phone: 501-682-1001).

• Arkansas Medicaid Provider Enrollment: Gainwell Technologies support for MMIS portal issues (Phone: 1-800-457-4454).

• DDS Intake and Referral: For general waiver program questions and policy guidance (Phone: 501-683-5687).

• PASSE Provider Relations: Contact individual PASSEs (Empower, Summit, CareSource, AR Total Care) directly for credentialing and contracting packets.

• Arkansas DHS Website: humanservices.arkansas.gov for access to DDS Certification Standards, provider manuals, and portal links.