ICF/DD and Subacute Care Facilities Benefit

ICF/DD and Subacute Care Facilities Benefit

IEHP has updated its requirements to align with the new Intermediate and Subacute Facilities benefit mandates. These mandates are described in the Department of Health Care Services (DHCS) All Plan Letters (APL 23-023 and APL 23-027) accessible below:

Credentialing Requirements:


For the initial credentialing, ICF/DD Homes must submit the below items in addition to the ICF/DD Attestation:

  • W-9 Request for Taxpayer Identification Number and Certification
  • Certificates of Insurance (Professional and General Liability)
  • City of County Business License (excludes ICF/DD-H and -N homes with six or less residents)
  • 5% Ownership Disclosure
  • Ancillary Facility Network Provider Application
  • The credentialing collateral and other supporting documents should be e-mailed to contract@iehp.org .