Each applicant is reviewed for certification by the PAA in which their place of business or service origination is geographically located. Once certified, an agency may expand service delivery to other geographic areas. Agencies can be certified to furnish services in any size area for which they can demonstrate they meet the qualifications of the Conditions of Participation and Service Specifications. For instance, a provider of home medical equipment may be able to serve consumers in all of Ohio's eighty-eight counties if the provider only ships a particular item to consumers through a delivery service, while a personal care provider would need to have several regional offices to serve consumers throughout the state in order to meet the requirements to provide supervision of aides, ensure back-up staff and furnish services seven days per week.
Once certified to provide services in one region, the provider only needs to request approval to expand into another region by requesting a contract to provide services in another region. The request is made to the regional PAA in the area it wishes to offer services.
While ODA-certified Medicaid Waiver Programs, including PASSPORT, are Medicaid waiver programs, ODA certification does not make an agency eligible to deliver traditional State Plan Medicaid services in Ohio. ODA-certified Medicaid Waiver Provider enrollment permits the provider to be reimbursed for ODA Medicaid waiver program services only.
Medicare certification as a home health agency is not a requirement for all ODA-certified Medicaid waiver program service providers. However, a certified provider of personal care service that is also a Medicare certified home health agency and a "traditional" Medicaid State Plan home health provider offers consumers who need both skilled home health services and unskilled personal care services with the most continuity of care options. Though all Medicaid Waiver services must be medically necessary, most ODA-certified Medicaid Waiver services are not medical in nature. Providers who are certified to provide State Plan Medicaid services, Medicare services and ODA-certified Medicaid waiver program services only bill each payer source for reimbursement that authorizes a particular service or a particular number of units of service. One exception is that a provider of Enhanced Community Living Service must be certified to provide all three types of services: ODA-certified Medicaid waiver program services, Medicare certified services and "traditional" State Plan Medicaid services.
