Massachusetts Medicaid Waivers & Home and Community Based Programs Overview

Massachusetts, known as The Bay State, has a highly developed 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 MassHealth, the state’s Medicaid program, in collaboration with the Executive Office of Health and Human Services (EOHHS), the Office of Long-Term Services and Supports (LTSS), and the Department of Developmental Services (DDS), Massachusetts offers multiple waiver programs that support individuals in home and community settings rather than institutional care.

Key waivers include the Frail Elder Waiver (FEW), which provides personal care, case management, and home modifications for seniors, and the Adult Supports (ASD) and Community Living (CL) Waivers, which offer residential, habilitation, and employment support for individuals with autism or intellectual and developmental disabilities (IDD). Additional programs include the Traumatic Brain Injury (TBI) Waiver, the Money Follows the Person (MFP) Waivers, and the Moving Forward Plan (MFP) Community Living Waiver, all of which promote independent living and community reintegration. Massachusetts also emphasizes Self-Direction options, allowing waiver participants to hire and manage their own caregivers for greater flexibility and independence.

Regulatory oversight in Massachusetts is managed through MassHealth and EOHHS, with additional provider licensing and compliance enforcement handled by the Department of Public Health (DPH) and the Division of Health Care Facility Licensure and Certification. The state operates under a Medicaid Managed Care model, integrating HCBS services with comprehensive medical and behavioral healthcare through Accountable Care Organizations (ACOs) and Managed Care Entities (MCEs). Massachusetts has also implemented Electronic Visit Verification (EVV) for personal care services, reinforcing accountability and compliance in home-based care programs.

Providers must navigate strict Medicaid provider enrollment, waiver-specific service authorizations, and rigorous quality assurance measures to participate successfully in the state’s HCBS system. With a focus on equity, community-based care, and person-centered planning, Massachusetts’ Medicaid waiver programs ensure that individuals receive high-quality, sustainable long-term care while maintaining independence, dignity, and inclusion in their 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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