Provider Index > Care at Home Waiver (CAH)
Provider Enrollment & Maintenance
Provides medical assistance to families with children living at home who have severe disabilities or medical conditions.
Complete this Enrollment Form if you are: - Applying for initial ENROLLMENT or ALREADY ENROLLED and enrolling another NPI, or
- Responding to a letter instructing you to REVALIDATE your enrollment, or
- Seeking REINSTATEMENT or REACTIVATION of your previous enrollment, or
- Reporting an OWNERSHIP CHANGE, or
- Reporting a RECEIVERSHIP
INSTITUTION Enrollment Form