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Traumatic Brain Injury Waiver

The Traumatic Brain Injury (TBI) Waiver Program is a long-term care alterative, which provides services that enable individuals to live at home rather than receiving nursing facility care. The program provides home and community-based services to West Virginia residents who are medically and financially eligible to participate.

KEPRO, contracted by the Bureau for Medical services (BMS) is responsible for the day to day operations and oversight of the TBI Waiver program. This includes conducting the evaluations that determine medical eligibility for applicants and members, performing provider agency certification and quality/utilization reviews, reviewing requests for prior authorization, providing training and technical assistance to all stakeholders and reviewing requests for prior authorization of TBI Waiver services.

Consumer education goals -KEPRO staff are available for training and technical assistance and to receive complaints about TBI Waiver service provision.

Provider education goals –KEPRO Provider Educators and other UMC staff are available for training and technical assistance to TBI Waiver providers.

TBI Waiver Department Contacts:
Phone: 866.385.8920
Fax:  866.607.9903
General Email: WVTBIWaiver@kepro.com

Additional Resources

Bureau for Medical Services
Website:  http://www.dhhr.wv.gov/bms/Programs/WaiverPrograms/TBIW/Pages/default.aspx   
350 Capitol Street, Room 251
Charleston, WV 25301
Phone:  304.558.1700
Fax:  304.558.4398

Fiscal Employer Agent (Personal Options)
Public Partnerships, LLC (PPL)
Website:  http://www.publicpartnerships.com/programs/westvirginia/WVTBI/index.html
Phone:  877.908.1757
EFax: 877-567-0071

Claims Processing
Molina Medicaid Solutions
Website:  https://www.wvmmis.com/default.aspx
For Providers:  888.483.0793
For Members:  304.343.3380
Fax:  304.348.3380

West Virginia Adult and Child Protective Services
Phone:  800.352.6513
Website:  http://www.dhhr.wv.gov/bcf/Services/Pages/default.aspx

WV CARES
Website: https://www.wvdhhr.org/oig/wvcares.html
Phone: 304.558.2018
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