Medicaid Provider Reimbursement Update Begins on January 1, 2010 - See details here.
ODJFS Response to Testimonies at Hearings on November 9, 2009 Concerning 3% Pay decreases.
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SECTION 309.30.75. REDUCTION IN COMMUNITY PROVIDER RATES:
The Director of Job and Family Services shall amend rules adopted
under section 5111.02 of the Revised Code as necessary to reduce, effective
January 1, 2010, the Medicaid reimbursement rates for the following
Medicaid-covered services to rates that result in an amount that is at least
three per cent lower than the amount resulting from the rates in effect on
December 31, 2009:
(A) Advanced practice nursing services;
(B) Ambulatory surgery center services;
(C) Chiropractic services;
(D) Durable medical equipment;
(E) Home health services;
(F) Ambulance and ambulette services;
(G) Physician services;
(H) Physical therapy services;
(I) Podiatry services;
(J) Private duty nursing services;
(K) Vision services;
(L) Clinic services, other than rural health clinics and federally qualified
health centers;
(M) Occupational therapy services;
(N) Dental services;
(O) Services provided under a home and community-based services
Medicaid waiver component, as defined in section 5111.85 of the Revised
Code, administered by the Department of Job and Family Services;
(P) Other services the Director identifies, other than services for which a
statute of this state sets the Medicaid reimbursement rate.
SECTION 309.30.76. DISPENSING FEE FOR NONCOMPOUNDED
DRUGS
The Medicaid dispensing fee for each noncompounded drug covered by
the Medicaid program shall be $1.80 for the period beginning January 1,
2010, and ending June 30, 2011.
SECTION 309.30.80. RESIDENTIAL STATE SUPPLEMENT
TRANSFER
Am. Sub. H. B. No. 1 128th G.A.
2885
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June 30, 2009
The following Rules Hearing will have a profound affect on active Homecare Providers in Ohio. If
at all possible, it is essential we all preview the proposed Rules (Attached) and prepare ourselves to
be in attendance on July 30, 2009 at 1:30 p.m. in Room 1932 of the Verne Riffe Center, 77 South
High Street, in Columbus, OH. to make our voices heard accordingly.
This is our opportunity to see first-hand what Rules are being decided, and how they will affect
our careers as Independent Providers. I've sent several informative emails lately, with very little
feedback; which is discouraging, as it appears we have conceded and have decided, "what ever
happens just happens". (myself included). However, it is not too late to become proactive, as these
Rules are not final (yet). For those whom can afford a day off work, I encourage everyone to be
present at this upcoming Hearing, regardless as to whether or not you speak or testify.
PUBLIC HEARING NOTICE
OHIO DEPARTMENT OF JOB AND FAMILY SERVICES
DATE: July 30, 2009
TIME: 1:30 p.m.
LOCATION: Room 1932, Vern Riffe Center, 77 South High Street,
Columbus, Ohio 43215
Pursuant to sections 5111.02 and 5111.85 and Chapter 119. of the Ohio Revised Code, the director
of the Ohio Department of Job and Family Services gives notice of the department's intent to
consider the rescission and adoption of the rules as identified below
and of a public hearing thereon.
This Rule is the one "Original" Rule being considered:
5101:3-45-05, entitled ODJFS-administered Waiver Program: Consumer Incident Management,
Investigation and Response System (IMIRS), is being proposed for adoption to replace rule
5101:3-12-29. This rule sets forth the standards and procedures.
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Rules being rescinded for minor changes:
5101:3-12-28, entitled Enrollment Process for ODJFS-administered Waiver Service Provider, is
being rescinded so that it can be renumbered 5101:3-45-04. A five-year review was completed in
accordance with section 119.032 of the Ohio Revised Code.
This rule sets forth the enrollment process for ODJFS-administered waiver service providers, and
sets forth provider enrollment criteria.
There are no substantive changes between rules 5101:3-12-28 and 5101:3-45-04.
5101:3-12-29, entitled Consumer Incident Reporting, is being rescinded so that it can be
renumbered 5101:3-45-05. A five-year review was completed in accordance with section 119.032 of
the Ohio Revised Code. This rule sets forth the standards and procedures for operating the
incident management, investigation and responses system (IMIRS) for ODJFS-administered
waivers. The rule applies to ODJFS and ODJFS-administered waiver service providers. ODJFS
may designate other agencies or entities to perform one or more investigatory functions set forth
in this rule.
There are no substantive changes between rules 5101:3-12-29 and 5101:3-45-05.
5101:3-12-30, entitled Monitoring Under ODJFS- administered Home and Community based
Service Waivers, is being rescinded so that it can be renumbered 5101:3-45-06. A five-year review
was completed in accordance with section 119.032 of the Ohio Revised
Code. This rule sets forth the monitoring requirements and procedures under ODJFS
administered home and community-based service waivers.
There are no substantive changes between rules 5101:3-12-30 and 5101:3-45-06.
5101:3-45-04, entitled ODJFS- administered Waiver Program: Provider Enrollment Process, is
being proposed for adoption to replace rule 5101:3-12-28. This rule sets forth the enrollment
process for ODJFS-administered waiver service providers, and sets forth provider enrollment
criteria. There are no substantive changes between rules 5101:3-45-04 and 5101:3-12-28.
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June 24, 2009
An Economic Study of LONG-TERM CARE COSTS IN OHIO
Home Care and Medicaid: Solutions for Ohio 2009—Update
June 12, 2009
An Important Message from Ohio Council for Home Care
A very bad situation in Ohio is getting much worse and funding for virtually every social
program in the state could be in jeopardy. On Thursday, state lawmakers learned Ohio is facing a
$3 billion deficit. Legislators working on the state budget have already indicated they will not
increase revenues, which potentially could mean huge cuts in state programs. Senate President
Bill Harris has said no program should be considered safe.
We must make every elected official aware of the dire consequences of not properly funding home
and community based services. The state budget, which must be approved by June 30, is now in
the hands of a six-member legislative conference committee, which for the most part will meet
behind closed doors. Publicly, there will be much discussion about the big picture - the large
deficit. We must make legislators look beyond that and understand that home care services saves
the state money. By rebalancing Medicaid funding in favor of home care versus institutional care,
the state can save millions of desperately needed dollars.
We Must Act Now!
Decisions made by legislators in the next few weeks could impact our ability to deliver services to
thousands of Ohioans in the manner they prefer. All of you have already done a great deal, but
more must be done. We will continue to fight in Columbus and tell our story, but the impact can
be much greater if we are all involved.
There is a letter titled "Support Home and Community Based Care Funding in Budget" in the
Legislative Action Center on our website www.homecareohio.org. You can use that letter or draft
your own message.
Contact your legislator by email, or phone TODAY! Make your voice heard. Working together,
we can better serve the thousands of Ohioans who depend upon us for quality care.
______________________________________________________________________________
Please contact me with questions or concerns at 614/885-0434 Ext 206 or via email at
kka@homecareohio.org. You can also contact our communications specialist, Bethany Hatheway
at the same number Ext. 203 or at bethany@homecareohio.org.
Ohio Council for Home Care is accepting applications for 2009 Membership. To access the
application, Click Here.
Keep Us Strong - Contribute to the Ohio Home Care and Hospice Defense Fund! For secured
online processing, Click HERE!
New Provider Enrollment Process
Effective June 1st, 2009, CareStar will no longer be processing enrollment applications for Ohio
Home Care Program providers. If you know anyone who will be requesting an application to
become a provider after June 1st, please inform them of our new process below.
The new provider enrollment process is web-based, and provides printable fact sheets and
applications for each provider type. Click here for Provider Enrollment Online
NOTE: CareStar Enrollment staff will continue to process any applications received prior to June
1st, and will be available for questions and technical support through July 1st, 2009.
_____________________________________________________________________________
May 5, 2009
It's that time again! We are being asked to take a preview of the Rules being considered; which
will affect most of our livelihoods.
Please click on the Rules link, and scroll down to :: Ohio Health Plans :: Providers :: Community
Services Policy and take the opportunity to "Comment" on these proposed Rules for the Waiver
Program. Our input makes a difference!
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March 2, 2009 3% Increase Raise Update
Dear Ohio Independent Providers:
Many have asked, "Where's the second 3% increase raise; which was to begin Jan. 2009?" Please
see the following update from the Ohio Council for Home Care: (whom by the way have been
representing us at these hearings).
Ohio Council's Fight for 3% Increase for Medicaid for FY2009 Will Not HappenFollowing his
testimony, Medicaid Director Corlett answered numerous questions posed by the members of the
House Finance and Appropriations Committee. A line of questioning from Rep. Sears (R-Toledo),
really interested Ohio Council Executive Director, and Communications Specialist who were both
in the audience during this testimony.
Following a detailed explanation of why nursing facilities should receive a rate increase and not be
faced with higher bed taxes, Rep. Sears asked Dir. Corlett to respond.
Citing information from the Ecomonic Study conducted by the Ohio Council for Home Care,
Director Corlett responded that the amount of money being dispursed to nursing facilities versus
home and community based care was skewed in a direction that he would like to see shifted. He
described how 65% of SNF are being paid for by Medicaid. He spoke of the importance of
examining what community based services could be provided outside the walls of nursing
facilities, and that some nursing facilities are now looking to provide those community care
services.
Rep. Sears responded that it is absolutely right to provide more home and community based
services. She then began to question the PASSPORT reimbursement increases. She said that the
amount that was increased was small and that it was impossible to have home and community
based services remain cost effective if they are not paid in a timely manner and in a manner that
will provide them the monetary support to continue.
Director Corlett responded that through this budget there will be full funding the PASSPORT
program, and he then deferred all other PASSPORT specific questions to Ohio Department of
Aging Director Riley.
Rep. Sears then asked a question regarding the hard fought for 3% increase that Ohio Council for
Home Care was able to secure in the last biennium budget (HB 119). After detailing that
Medicaid providers were to receive their first three percent increase on January 1st, 2008 and the
second increase on January 1st, 2009, Rep. Sears then questioned that by having the first increase
delayed until July 1st, of 2008, would we assume that the second increase should be given on June
30th, 2009.
Dir. Corlett explained that the three percent increase was the first increase to have been given in 8
years (while for home care providers it had been 10 years). He further explained that this budget
bill does not assume the second three precent increase will happen.
Rep. Sears followed up by asking that if this second increase does not happen then it can be
assumed that the desires of the Ohio General Assembly in HB 119 were not acknowledged.
Essentially the Medicaid Director would not be doing what was said under the previous
biennium bill.
Director Corlett responded, "The resources simply aren't there."
SOURCE: Ohio Council for Home Care (Newsletter)
Independent Provider Members of the OCHC received the full version of this newsletter.
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February 23, 2009 Update from the OHCP
Unauthorized Background Checks
Non-Agency Providers (RN's, LPN's and PCA's) are receiving background check notifications that
were not authorized by the Ohio Department of Job and Family Services (ODJFS). Disregard
these unauthorized notifications.
You should only comply with the background check requirement sent from ODJFS in
letter-form. No other entity has the authority to notify or request this annual requirement.
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December 17, 2008: Provider Rule Change
Time-Limited Provider Agreements/Re-enrollments
House Bill 119 Provider Agreement Changes;
House Bill 119 Provider Agreement Changes
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July 18, 2008: Medicaid Providers now able to
submit claims online. Medicaid Provider Portal
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