Site Visits

Federal and state laws require some providers to have pre- and post-enrollment site visits to ensure they are following Ohio rules and regulations for being a Medicaid provider. (See OAC 5160-1-17.8 – formerly OAC 5101:3-1-17.8 for additional information about provider screening requirements). In Ohio, Public Consulting Group, Inc. (PCG) conducts these site visits on behalf of the Ohio Department of Medicaid (ODM). Site visits are conducted at the provider's service location without prior notification or appointment.

 

When PCG representatives arrive at your office, they will have business cards and a letter of introduction for your verification. Please take a few moments to answer their questions and allow them access to your facility. This will help to complete your site visit smoothly. During your site visit, PCG representatives will review various aspects of your business and will ask to view specific documentation. Failure to answer their questions and cooperate may affect your enrollment or current provider status with Ohio Medicaid.

 

If providers are out of compliance with rules and regulations, PCG representatives will educate the provider regarding any deficiencies. The provider will have an opportunity to ask follow-up questions or for clarification.

 

After the site visit, non-compliant providers may receive a letter from ODM further outlining areas where the provider is non-compliant. This notification is called a "Notice of Operational Deficiencies" (NOD). The NOD will clearly outline the areas where deficiencies were found. If you receive a NOD, you must submit a "Plan of Correction" (POC) within 30 days outlining how you will correct the noted issues and the timeline in which they will be corrected. While there is no official format for a POC, it must include the following:

  • An explanation of any actions the provider has initiated in order to correct the deficiency;
  • What steps the provider has taken to ensure similar issues or other deficiencies will not recur in the future; and
  • The provider's signature and date of submittal.

The NOD will outline these requirements along with the mailing address for where to send the completed POC.

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Contact Us

For more information about Public Consulting Group and how we can assist you in delivering or receiving Home and Community Based Waiver Services, please contact us at the following:

Ohio HCBS
155 East Broad Street 8th Floor Columbus, OH 43215
Phone: 877-908-1746
Fax: 614-386-1344
E-mail: ohiohcbs@pcgus.com