Notice of compliance requirements due to Appendix K flexibility unwinding for providers
Personal Care Aides
Information from the Ohio Department of Medicaid regarding Appendix K flexibility unwinding was sent to impacted providers via email due to the end of the public Health Emergency. Please see the detail for Personal Care Aides HERE.
Medicare Certified Home Health Agency and Otherwise Accredited Home Health Agencies
During the Public Health Emergency, through Appendix K authority, Ohio Department of Medicaid (ODM), the Ohio Department of Developmental Disabilities (DODD), and the Ohio Department of Aging (ODA) were permitted to allow waiver providers with an active Medicaid provider agreement to furnish waiver services across the delivery systems, without being subject to additional provider standards and certification processes specific to the waiver programs. ODM has decided to discontinue this flexibility and return to previous screening and certification standards to ensure proper safety and security measures can be taken to prevent patient incidents and continuity of care.
If your organization would like to continue furnishing personal care aide services as a Medicaid provider, please follow the steps below:
Please consider pursuing options such as becoming a type 60 (Medicare Certified Home Health Agency) or type 16 (Other Accredited Home Health Agency). Each of these requires that you meet the certification or accreditation requirements of these provider types before you can submit a new application to Ohio Medicaid to be enrolled as that provider type.
Once your organization becomes qualified as either a Medicare Certified Home Health Agency or an Otherwise Accredited Home Health Agency, and you wish to enroll as this new provider type with Ohio Medicaid, please access the Disenrolling a Provider from Ohio Medicaid Quick Reference Guide. This guide includes step-by-step instructions on disenrolling your current provider type and enrolling as a group/organization.
Note: If you no longer wish to provide Personal Care Aide services and opt not to pursue certification or accreditation as a Medicare Certified Home Health Agency or an Otherwise Accredited Home Health Agency, please provide appropriate notice to impacted members and their case managers. You do not need to take any action with ODM Provider Enrollment, and on January 1, 2024, ODM will automatically remove the Personal Care Aide services specialty and contracts. Your agency will continue to be enrolled as a waiver agency provider but not eligible to provide Personal Care Aide services.