Missouri Medicaid Waivers & Home and Community Based Programs Overview
- Waiver Policy Analyst
- Oct 31, 2024
- 2 min read
Missouri, known as The Show-Me State, has a well-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 the Missouri Department of Social Services (DSS), MO HealthNet Division (MHD), and the Department of Mental Health (DMH), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings rather than institutional care.
Key waiver programs include the Aged and Disabled (A&D) Waiver, which provides personal care, respite, and in-home nursing services for seniors and adults with disabilities, and the Comprehensive (COMP) and Community Support (CS) Waivers, which support individuals with intellectual and developmental disabilities (IDD) through residential, employment, and behavioral health services.
Additional waivers include the Independent Living (IL) Waiver, the Medically Fragile Adult Waiver, and the Adult Day Care Waiver, all of which promote independence and community integration. Missouri also offers Self-Directed Services, allowing participants greater control over their care planning and provider selection.
Regulatory oversight in Missouri is managed through MHD, DMH, and the Department of Health and Senior Services (DHSS), Division of Senior and Disability Services (DSDS), which ensures provider compliance and licensing requirements. Missouri operates under both fee-for-service and managed care models, with HCBS services coordinated through MO HealthNet Managed Care Organizations (MCOs) to improve care integration and cost efficiency. The state has also implemented Electronic Visit Verification (EVV) for personal care services, reinforcing compliance and service integrity.
Providers must navigate Medicaid enrollment, waiver-specific billing procedures, and strict quality assurance measures to successfully participate in Missouri’s HCBS programs. With a focus on community-based care, person-centered planning, and long-term service sustainability, Missouri’s Medicaid waiver system ensures that individuals receive high-quality, flexible supports while promoting independence, dignity, and full participation in their communities.
Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.
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