Resources for Professionals

Administrative Rules

Review administrative rules governing the Department of Aging's programs and services. Participate in the rule development process by participating in public comment periods, public hearings and legislative review of draft rules. Review recent rules updates by other state agencies that impact services for older adults.

 

Provider Certification

Learn about the various provider types used in the Department of Aging's programs and services. Review certification requirements and apply for provider certification using our online system.

 

Data Center

Review program data, such as waiver program participation and grant amounts.

 

Electronic Visit Verification

Learn about the Electronic Visit Verification (EVV) requirement and view recent updates.

Education Center

Access educational and training resources tailored to aging network provider staff and management, including frequently asked questions, service training, and education about age-related illnesses and conditions.

 

Nursing Home Quality Improvement

Each Ohio nursing home is required to participate in at least one quality improvement project every two years to maintain their licensure. Programs are developed or approved by the Office of the State Long-Term Care Ombudsman.

 

BELTSS

The Board of Executives of Long-Term Services and Supports (BELTSS) develops and enforces standards for nursing home administrators, formulates appropriate examinations, and issues, revokes, and suspends licenses.

Messages

Financial Exploitation Response Survey

When someone suspects or identifies potential elder fraud or financial exploitation, they frequently find themselves confronted with a bewildering maze of organizations and bureaucratic requirements. This often comes at a time of vulnerability or crisis that can result in people making decisions based on incomplete, and sometimes inaccurate, information about their options.

The Department of Aging would like to gather information with the goal of understanding how suspicions and allegations of elder fraud and financial exploitation are identified and handled in Ohio in order to inform inter-agency work to improve the current system.  Understanding where we are now will help identify necessary improvements.  Your candor and that of your team is imperative.

The survey will take 5-10 minutes to complete.  Please share the link with as many partners who interact with older adults as possible.  The survey will close Nov. 13, 2019. Thank you in advance for your contribution.

Access the survey...

Providers Subject to Federal Heightened Scrutiny

Change of Ownership Interest or Oganizational Structure

Seventh Database for Criminal Background Checks

Amendments to rules 173-9-03 and 173-9-03.1 of the Administrative Code take effect March 1, 2019.

Since 2013, the rules have required reviewing the status of persons being checked in six databases. One of the amendments will require checking a seventh database, the Medicaid Provider Exclusion & Suspension List. The Ohio Department of Aging (ODA) amended the rules to require the seventh database to keep standards for disqualification the same between ODA and the Ohio Department of Medicaid, which already disqualifies persons being checked.

Learn more...

Standard Authorization Form

Providers should be aware that a new form, Standard Authorization Form (Form Number: ODM 10221), is now available from the Ohio Department of Medicaid. The purpose of the form is to improve care coordination for a patient across multiple providers by making it easier to share protected health information in a secure manner. The form is applicable to all covered entities in Ohio. It is not required to be used, but a properly executed form must be accepted by the receiving entity. The requirement to accept a properly executed form is applicable within 30 days of January 3, 2019.

Elimination of FFS/QMB Monthly Cards

Effective October 2018, applicants not enrolled in Managed Care will no longer receive monthly fee for service (FFS) Medicaid or Qualified Medicare Beneficiary (QMB) cards on a monthly basis.

The FFS and QMB cards will no longer display dates or Medicare data. The following language will display: "Retain this card. This is your permanent card. You will not receive a new card every month."

Individuals will receive a new card only for:

  • New approvals,
  • Rescind on a denial and approval,
  • Reapplication,
  • Renewal,
  • Disenrollment of Managed Care on current date, or
  • Aid code changes from QMB to non-QMB or vice versa.

Providers have access to the Medicaid Information Technology System (MITS) provider portal. Providers can log in to access eligibility information for individuals being served through PASSPORT and Assisted Living waivers. Providers should complete this verification action monthly to verify individuals have current Medicaid eligibility.

For more information on how to access the MITS provider portal, visit the Medicaid website and click "Providers" and then "MITS resources."

Application Fee

In accordance with federal requirements described in 42 CFR 445.460 and per Ohio Administrative Code 5160-1-17.8, the Ohio Department of Aging will begin collecting a Medicaid application fee effective April 15, 2016.  The fee is currently $586 per application and is non-refundable. The fee applies to agency and assisted living applicants only. The fee will not be required if the agency or assisted living applicant has paid the fee to either Medicare or another state’s Medicaid provider enrollment program (such as the Ohio Department of Medicaid, the Ohio Department of Developmental Disabilities, or outside of Ohio) within the past two years.  However, the Department of Aging requires the agency or assisted living applicant submit proof of payment with their application.

The Medicaid application fee does not apply to individual or non-agency applicants.

Social Security COLA

The Social Security Administration announced a two percent Cost of Living Adjustment (COLA) effective Jan. 1, 2018. The Assisted Living Waiver established room and board rate is the current SSI federal benefit rate minus $50.00.  Please contact your Area Agency on Aging for more information.

Heightened Scrutiny Workflow

On March 17, 2014, the Centers for Medicaid and Medicare Services (CMS) issued its final rule regarding settings for home and community-based services (HCBS) offered through the Assisted Living Waiver and the PASSPORT Waiver. For those settings that are presumed to be institutional, the state may submit evidence to CMS demonstrating the setting does not have the qualities of an institution. Accordingly, to ensure the Heightened Scrutiny process is integrated into the Ohio Department of Aging (ODA) workflow to become a certified ODA provider, ODA will adopt this process for reviewing new provider applications.

Consumer-Directed Providers

On Tuesday, October 6, 2015, Chief Justice John Roberts of the United States Supreme Court denied an application that would have stayed implementation of the US Department of Labor's Home Care Final Rule. The rule applies minimum wage and overtime protections to domestic service workers.

This change is applicable to non-agency waiver nurses, non-agency home care attendants, choices home care attendant and consumer-directed personal care providers effective Jan. 1, 2016.

ODA has issued guidance to non-agency waiver nurses and home care attendants and Choices home care attendants and consumer-directed personal care service providers regarding overtime billing.