Ohio Medicaid Provider Agreement, Enrollment, and Program Integrity
Sets out the duties the Agency accepts when it signs an Ohio Medicaid provider agreement: who may provide Medicaid home health, keeping enrollment, ownership and location information current within thirty days, screening for sanctioned persons, protecting recipient information, cooperating with reviews, site visits and audits, and responding to enrollment moratoria and payment suspensions.
About this policy
- Policy number
- OH-HH-BUS-04
- Version
- 1.0
- Main rule
- OAC 5160-1-17.2
- Library
- Ohio home health · 59 policies
- Category
- Business
- Sections
- 18
In short
- The Agency follows its Ohio Medicaid provider agreement and tells ODM of changes within thirty days.
- Everyone is checked every month to make sure they are not excluded from Medicaid or Medicare.
- If anyone from ODM, the Auditor of State or the Attorney General asks for records or visits, tell the Administrator at once.
- Never change or create records because of a review.
What's inside
18 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (OAC 5160-1-17.2)
- 5. Duties Under the Provider Agreement
- 6. Keeping Enrollment Current
- 7. Screening Owners, Staff, and Contractors
- 8. Reviews, Site Visits, and Audits
- 9. Enrollment Moratoria
- 10. Payment Suspension
- 11. Responsibilities
- 12. Records and Compliance Monitoring
- 13. Staff Training
- 14. References
- 15. Related Policies and Forms
- 16. Approval
- 17. Revision History
An inspector may ask
- Show me your Ohio Medicaid provider agreement and your last revalidation.
- When did you last tell the Ohio Department of Medicaid about a change, and how quickly?
See Cura Core with your agency's name on it.
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