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Tags Posts tagged with "DP Form"

DP Form

ODP Announcement 22-006 is to inform all Waiver Providers and Vendors whose last digit of their Master Provider Index (MPI) number is 3, 4, or 5, as well as new providers who enrolled in the 2020–2021 fiscal year, that they must submit their qualification documentation to their Assigned AE and/or the Office of Developmental Programs’ (ODP) Bureau of Supports for Autism and Special Populations (BSASP). This documentation is due between February 1, 2022 and March 31, 2022

Documentation must include a completed DP 1059 form and/or DP 1088 form, Provider Qualification Documentation Record (providers must use the most recent version found on MyODP), and any other required supporting documentation. For reference to provider qualification, please see Pennsylvania Bulletin Volume 49, Number 40, Subsections 6100.83-84, which contains provider qualification citation specifications.

Inquiries about this communication regarding the ID/A qualification process should be sent to the ODP Provider Qualification inbox. Inquiries about this communication regarding the AAW qualification process should be sent to the AAW Provider Qualification inbox.