This section provides all the details on applying to become a provider for the Developmental Disability Waiver (DD), Medically Fragile (MF) and Supports Waivers (SW).
Application Documents
The documents below will assist you with the application process.
Service Standards
Please visit each waiver programs’ webpages for the service standards to complete your application.
Billing
For billing assistance, contact Conduent at 1-800-299-7304 or via email at NM.Providers@hsd.nm.gov.
Rates of reimbursement for each service can be found in each Waiver Program’s published Fee Schedules.
Secondary Freedom of Choice
The Secondary Freedom of Choice (SFOC) form is utilized by case management provider agencies to present to registrants when selecting DDW, MFW and Supports Waiver services.
To request a SFOC form, please contact us at cpb.peu@state.nm.us.
Policy and Procedure Exception Request
Pursuant to the SFOC Policy and Procedure, provider agencies cannot not deny services to any individual once a SFOC has been signed, unless they can demonstrate that they do not have the capability to ensure the health and safety of that individual.
If your agency has received a signed SFOC and is unable to accept the individual for the reasons outlined within the SFOC Policy and Procedure, please fax a copy of the SFOC Policy & Procedure Exception Request Form to one of our Regional Offices for review.
