Provider Certification

Prior to applying for certification, please read and understand the conditions of participation and service requirements for which you are seeking certification. View this information as well as all the current effective rules.

Please review each of the options below and select the appropriate provider type for which you would like to apply for certification. To review certification instructions and the link to our online application, click on a provider type below.

Individual Providers

A person who will be the employee of the PASSPORT consumer and is directly supervised by the PASSPORT consumer.

Choices Home Care Attendant
This type of provider will furnish specific activities to support the needs of an individual consumer. (Example: general household assistance, etc.)

Consumer-Directed Personal Care Provider
This type of provider will furnish personal care services and homemaking tasks appropriate to a consumer’s need. Education requirements apply.

Long-Term Care Agency Providers

Long-Term Care Agency Provider
This type of provider is a legally-organized entity which employs staff to perform the type of services the agency is seeking to be certified. (Example: Agency provides personal care service – employees include home health aides, nurse, etc.)

Long-Term Care Non-Agency Providers

Long-Term Care Non-Agency Provider
This type of provider is a legally-organized entity which is owned and controlled by one person and does not employee staff. (Example: Bob’s Handyman Service – is a sole proprietor and does not employee staff.)

Home Care Attendant Non-Agency Provider
This provider type is an unlicensed individual who will perform skilled tasks which would otherwise be completed by a nurse. This provider type will secure the services of an RN or an LPN (at the direction of an RN). Education requirements apply.

Waiver Nursing Non-Agency Provider
This provider type is a registered nurse (RN) or licensed practical nurse (LPN) at the direction of an RN who is not employed through an agency.

Assisted Living Waiver Providers

Assisted Living Waiver Provider
This provider type is a residential care facility in receipt of a license from the Ohio Department of Health.

Messages

Background Checks for Paid Direct Care Positions

Pursuant of administrative rule 179-09-04 and 179-09-04.1, the Ohio Attorney General Office has notified the Ohio Department of Aging of new pricing for FBI and BCI background reports. Effective January 1,2019, FBI has increased the cost of the background check by $1.25.  Additionally, there will be an increase to the cost of the BCI background check by $1.25; this new change will take effective April 1st, 2019.

For more information or additional questions please visit the Ohio Attorney General's Office website or by phone at 877-224-0043.

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 $569 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.