Maryland Medicaid Waivers & Home and Community Based Programs Overview

Maryland, known as The Old Line State, has a well-structured Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.

Administered by the Maryland Department of Health (MDH), Office of Long-Term Services and Supports (OLTSS), and the Developmental Disabilities Administration (DDA), the state’s Medicaid waiver programs allow eligible participants to receive services in their homes or community settings rather than institutional care.

Key waiver programs include the Community Options Waiver, which provides personal assistance, home modifications, and assisted living services for seniors and individuals with disabilities, and the Community Pathways Waiver, which offers habilitation, behavioral support, and employment services for individuals with intellectual and developmental disabilities (IDD). Additional programs include the Community First Choice (CFC) Program, which provides self-directed personal care services, the Brain Injury (BI) Waiver, and the Medical Day Care Services Waiver, all aimed at supporting independent living and community integration.

Regulatory oversight in Maryland is managed through MDH, OLTSS, and DDA, with provider licensing and compliance enforcement handled by the Office of Health Care Quality (OHCQ). Maryland operates under a Medicaid Managed Care model known as HealthChoice, which integrates primary, behavioral, and long-term care services. The state has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring greater accountability and compliance in home-based care programs.

Providers must navigate Medicaid provider enrollment, stringent quality assurance measures, and service authorization processes to participate successfully in Maryland’s HCBS system. With a strong emphasis on self-directed services, person-centered planning, and workforce development, Maryland’s Medicaid waiver programs ensure that individuals receive high-quality, community-based supports while promoting independence, dignity, and inclusion in their local communities.

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Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.

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