Waivers offer an array of services and benefits such as choice of qualified providers, due process, and health and safety assurances.
The name waiver comes from the fact that the federal government "waives" Medical Assistance/Medicaid rules for institutional care in order for Maryland to use the same funds to provide supports and services for people closer to home in their own communities.
In Maryland, the Developmental Disabilities Administration administers the Community Pathways Waiver on behalf of Maryland Medicaid. Each waiver has its own unique set of eligibility requirements and services.
The Community Pathways Waiver provide supports and services to eligible persons with developmental and intellectual disabilities from birth and older so they can remain in their home and community. Maryland has set criteria to determine eligibility for Medicaid waiver enrollment. Financial eligibility is based only on the income of the individual, not the income of the parents.
The Department of Health and Mental Hygiene, Office of Health Services must apply to the Centers for Medicare and Medicaid Services to have waivers approved and they are then monitored by this federal agency. Waivers are approved for an initial period of three years and are renewed for a five-year period. Waiver renewals are based on satisfactory provision of waiver services, meeting state assurances and a written application that describes how services will be provided during the renewal period.
Before a waiver ends, the Office of Health Services must submit a renewal request to the Center for Medicare and Medicaid Services in order to continue to receive waiver funding.