What you will be asked for

First: are you a business, or an employee?

This decides everything else, so it comes first.

If you run your own business — you set your rates, you decide how and when the work is done, you offer the service to the public, you use your own equipment, you send invoices — you are a business vendor. You get a 1099 at the end of the year, you handle your own tax and insurance, and the pages here are about you.

If you work the hours the participant needs, in the way they direct, clocking in and out, using their home and their equipment, you are almost certainly an employee — of the participant, not of the FMS. California law decides this, not what either of you would prefer to call it. For personal care, respite and most in-home support, employee is the usual answer.

Employees are taken on through a different route: the participant hires you, the FMS runs the payroll, tax is withheld, and workers' compensation covers you. It is more paperwork at the start and considerably more protection afterwards.

If you are unsure, say so before you start work rather than after. Getting this wrong is expensive to unwind, and the person who carries most of that cost is usually the participant.

What every provider sends

The wording and the forms differ between providers, but the substance is consistent, because most of it is required by somebody other than the FMS.

Who you are and what you do — your legal and trading name, contact details, the service you are providing, and your rate.
IRS Form W-9 — your legal name and taxpayer ID, so you can be issued a 1099. The name on this form governs everything: you will be paid in that name and no other.
California Form 590 — whether California requires tax to be withheld from your payments.
How you want to be paid — bank details for direct deposit, or an address for a check.
Your business license, or an explanation of why your city or county does not require one. Plenty of legitimate providers do not need one; what is needed is a straight answer rather than a license.

What some providers also send

A professional license or certification, where the service requires one — nursing, speech, occupational or physical therapy, behavior services and so on. The waiver makes the FMS and the participant responsible for verifying it, so how that is done — a copy from you, a lookup with the issuing board, or both — is up to the provider you are dealing with. Services with no licensing category — a gym, an art class, a music teacher — are not expected to produce one.
A background check, for respite and direct personal care.
Electronic Visit Verification acknowledgments, for services that require EVV — broadly, personal care and in-home services delivered to someone at home. If this applies to you, there will be an app or a phone process to record the start and end of each visit, and the record matters as much as the invoice.
A service agreement naming the participant, where you bill at anything other than an hourly or daily rate — per session, per month, per course. This one is a DDS requirement rather than an FMS preference, it has ten things it must contain, and it has to be updated every year. What goes in it.
A written agreement for recurring monthly charges, such as a gym or a membership billed to a card.

What gets checked

Three things, and it is worth knowing they happen so that none of them is a surprise.

Your licenses, professional and local, as above.
Federal and state exclusion lists. Anyone paid with Medicaid money is checked against the federal LEIE maintained by the HHS Office of Inspector General, and California's Medi-Cal Suspended and Ineligible Provider List. This is not a credit check and it is not personal; it is a condition of the funding, and being on either list stops payment regardless of anything else about you. Both lists are rebuilt monthly, and checking is not a one-off — but how often each FMS re-checks is that provider's own decision, so ask yours if you want to know. Being added to a list between checks is the thing to avoid on your own account: tell your FMS before they find out.
Your taxpayer ID, matched against IRS records. A mismatch between the name and the number on your W-9 is the single most common reason a first payment is held up, and it is usually a typo.

And again every year

The waiver requires verification “upon selection and annually thereafter through the IPP process”. So there will be something to do each year — confirming your details, resending whatever has expired, signing again. What it is called and how much of it there is varies by provider; that it happens at all does not.

The practical advice is the same from every direction: send a renewed license the day you get it. An FMS cannot keep paying against a qualification it can no longer verify, so what happens next — a hold, a query, a deadline — is a question for your own provider, and none of the answers are good ones.

Before you start work

Two rules that cost providers real money when they are not known in advance.

The service has to be in the participant's spending plan. The spending plan is the document that says what their budget may be spent on, line by line, and a service that is not in it cannot be paid for — not late, not retrospectively, not as a favor. If you are asked to do something outside what was agreed, the participant needs their plan changed first.

Ask when you are cleared to start, and get the answer in writing. The waiver puts verification before service — “upon selection” — and an FMS has to finish checking you before it can pay you. Whether anything you do in the gap can be paid for afterwards is a question each provider answers for itself, and some answer it with a flat no. If somebody is keen for you to begin on Monday and the forms went out on Friday, find out which answer yours gives before Monday, because the risk in that gap is yours.

The first of these follows from the directives on billing, which allow payment only for services in the participant's spending plan. The second varies between providers: no rule sets a single answer, so the only reliable one is the one your own FMS gives you.

What happens next

Getting paid — what your invoice has to show, who approves it, and what cannot be paid for.
Back to the overview — including why none of this is the same as regional center vendorization.