Service Provider / Vendor Intake
Welcome
to FMS Pay and Self-Determination!
Thank you for your interest in serving participants in
California's Self-Determination Program (SDP). Service providers like you are a
critical component to the continued success of SDP!
Important:
Please note, this process is intended only for VENDORS to
enroll with FMS Pay. FMS Pay does not hire employees, does not issue
W2s, and is not an employer of record. All entities onboarding with
FMS Pay are considered vendors. If a W2 employee arrangement is needed, please
connect with the participant to discuss other FMS options, as FMS Pay is not
appropriate in that situation.
Here are some critical details for you to know, as you
provide services to an individual enrolled in SDP:
Self-Determination is a program offered to Individuals with
Developmental and Intellectual Disabilities (IDD) by the State of California,
through the Regional Center system. It allows participants to utilize funds in
non-traditional ways, and explore services not previously funded by the
Regional Center. Information at: https://www.dds.ca.gov/initiatives/sdp/
The participant (client) has a spending-plan, which has been
certified by the Regional Center. Essentially, this means a certain dollar
amount has been allocated for your services. The participant should discuss
their service budget with you, and negotiate a rate for those services directly
with you. FMS Pay is authorized to pay up to the authorized amount in the
spending-plan. If the participant exceeds their authorized amount, the
participant is financially responsible for the excess. FMS Pay recommends you
maintain a contract with your client if necessary. You are not entering into
any contracts with FMS Pay; your contract is directly with the
client/participant. If the client exceeds their budget, they may have to
private pay for your services.
FMS Pay acts as a “pass-thru" for funding. FMS Pay does
not "hold” the participant's funds. When an invoice for services is
received, FMS Pay bills the services to the Regional Center under the
appropriate Service (billing) Code. The Regional Center then confirms available
funding and releases those funds to FMS Pay. Upon receipt of those funds, FMS
Pay can issue payment to the provider. Regional Centers release funds on a
weekly basis.
Payment Turnaround:
Invoices are typically paid within around 3 weeks of
receipt, depending on the timing of the Regional Center's pay run. Delays can
occur if the client runs out of funds, however, or if the Regional Center
experiences a technical or fiscal department failure. We cannot guarantee exact
payment dates in all situations.
To ensure Medicaid Waiver
compliance and participant safety, FMS Pay is required to perform due
diligence for all service providers and verify specific items.
This includes obtaining the following:
- A copy of your business license (e.g., City tax certificate).
- A copy of any valid professional/competency licensing, if applicable (e.g., for speech, occupational, physical therapists, chiropractors, dentists, etc).
- Confirmation that the service provider is not listed on the US Department of Justice's "List of Excluded Individuals/Entities" or the CA Department of Health Care Services' (DHCS) "Suspended/Ineligible Provider List."
- Copies of certificates/degrees or other backup documents to support the “Vendor Qualifications” requirement as indicated in Medicaid Waiver Appendix C. (Medicaid Waiver requirements can be found on our website).
Settings that are designed specifically for groups of
individuals with developmental disabilities must be assessed prior to beginning
the SDP service. Only services that are HCBS Final Rule Compliant can be
purchased through the Self-determination Program (SDP). Applicable settings and
the evaluation form can be found on our website. The evaluation form must be
signed by the vendor (you), the client, and the Regional Center and sent to the
FMS for recordkeeping.
DDS requires any individuals providing “direct care
services” must obtain a background check prior to rendering services. Specifically,
defined as, “assistance with dressing, grooming, bathing, or hygiene.”
The background check forms and requirements are available on
our website.
Please note, background checks from other agencies such as IHSS, Social
Services, etc. are NOT applicable in SDP. SDP has a specific background
check process that must be followed.
FMS Pay must capture an IRS W9 for all vendors, and must
comply with IRS regulations related to issuance of 1099s, as well as compliance
with all backup withholding orders.
FMS Pay runs all vendors through the IRS TIN MATCHING
service. If there is not a match, the vendor will be rejected for onboarding
until a valid W9 is received.
FMS Pay cannot offer tax advice; Vendors should consult a tax
professional if unsure how to complete the IRS W9.
FMS Pay must capture a CA-590 or CA-587 tax form for
all vendors. Typically, in-state vendors complete a CA-590 with a CA-587
typically being applicable to out of state entities. However, FMS Pay cannot
offer tax advice. Vendors should consult a tax professional if unsure which
state tax form is appropriate.
Vendors that bill under certain service codes may be
required to comply with federal EVV requirements. Typically, these are in home
services such as Respite. Vendors who are required to comply with EVV will need
to register in the state’s EVV Aggregator system and report all client visits.
Details can be found at
Resources related to EVV are also available on our website.
Annual Vendor File Recertification:
Vendors will be asked annually to re-certify their vendor
file so that the FMS can confirm the vendor is still eligible for payment in
SDP. This is required by Medicaid Waiver. Please anticipate submitting your
licenses, certificates, etc. on an annual basis if you intend to provide
services in SDP ongoing.
Final Notes:
We acknowledge SDP can be an exciting program for our
participants, however what is often overlooked are the compliance and
regulatory aspects of SDP, which can be quite complex! Our goal is to make the
process as smooth as possible, with the understanding that there are certain
Medicaid requirements in place we must follow as an FMS. To make your vendor
onboarding experience a success, please carefully review the requirements,
review the resources on our website, and have all documents available when
preparing to onboard as a vendor.
SERVICE PROVIDER INTAKE PACKET:
- Service Provider Intake (ACH Payments) - Secure & convenient. Results in fastest payment. Commonly known as "direct deposit."
Please note, due to systemic problems with USPS, including unprecedented levels of mail theft, FMS Pay no longer offers check payments unless the vendor can demonstrate that ACH payments "represents a substantial financial hardship for the provider." Check payments are not a secure or efficient method of payment at this time. Thank you for enrolling in ACH.
Service providers should review the Vendor FAQs and DDS Invoice Requirements, as well as the invoice submission policy.
If you have any questions, please reach out to connect@fmspay.com
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