Passport covered services and the maximum allowable rates for services furnished under the passport waiver. Providing an alternative to nursing home care passport central ohio area agency on aging 3776 south high street, columbus, ohio 43207 phone. The state of ohio has worked closely with the federal government to improve the way health care services are provided by. To determine if you may be eligible for medicaid, visit ohio benefits. Passport is a service of the area agency on aging district 7, inc. Programs and services to help you or a loved one with care needs, wherever you call home. The condition results in substantial functional limitations in three or more of the following areas of major life activities. This odmadministered waiver program provides eligible individuals in need of longterm care facility services with a costeffective home and communitybased alternative. This waiver program serves individuals on medicaid with longterm care needs that, in the absence of certain services, would need to depend on a hospital or nursing facility.
C the passport hcbs waiver covered services and eligibility requirements are set forth in chapter 516031 of the administrative code. Assisted living waiver program this medicaid program covers care in an assisted living facility for eligible individuals who use their resources for other living expenses. Passport hcbs waiver program services specifications. A csv file type can be opened in microsoft excel or other spreadsheet programs. Describe how the amount of reserved capacity was determined. Waivers are one way to pay for the services that support people with developmental disabilities. Passport waiver choices waiver assisted living waiver other other specify. Passport helps countless older people stay in their own homes and live with independence and dignity. The client agrees to pay for services not covered by the oregon health plan ohp, the oregon health authority oha or oha. Enrollment on the ohio home care waiver program is available for medicaid eligible individuals under the age of 60, who meet an intermediate or skilled level of care, and other program eligibility requirements. I authorize the county department of job and family services cdjfs and its designees to explore my eligibility for medicaid coverage of hcbs waiver services. For a more comprehensive fee schedule, click here to return to the ohio medicaid fee schedule page. If you have additional general questions about the new health partner contract form.
Ohio medicaid passp contract 05012020 procedure code procedure description pricing indicator rate type mod1 mod2 mod3 mod4 max fee max fee eff. Passport medicaid waiver program ohio department of aging. Passport fact sheet ohios passport program helps medicaideligible older ohioans stay in their homes. Ohio home care waiver program fact sheet ohios medicaid inhome care program for people under age 60 the ohio home care waiver program is an inhome longterm care option for financially eligible children and adults who have significant disabilities andor mental health needs. The ohio department of medicaid will assign a case management agency to conduct a level of care assessment of your needs.
Evaluation of ohios assisted living medicaid waiver. Review date undated passport hcbs waiver provider initial and ongoing certification. Passport waiver individual options waiver assisted living waiver level one waiver to apply for waiver services. Ohios appendix k submission for the nfloc 1915c waiver delivery system oh.
To learn more about the passport waiver call the ohio department of aging at. D the maximum allowable payment rates for passport hcbs waiver program services are listed in appendix a to this rule. Clicking on a frequently asked question faq below will reveal the answer. The ohio home care waiver is designed to serve frail, disabled adults between 18 and 59 years of age, who have functional limitations, and who have been referred by a physician or other medical authority. The ohio department of aging oda is seeking proposals from parties interested in organizing and executing an independent evaluation of passport preadmission screening system providing options and resources today, the states home and communitybased services medicaid waiver program. Passport waiver choices waiver assisted living waiver pace other specify. It also allows these individuals to have more control of their lives and remain active participants in their communities. Chapter 516031 medicaid home and community based services waiver portion of the passport program. Passport ohios nursing home alternative passport is an ohio medicaid program that helps eligible older adults receive care and support in their homes, instead of a nursing home. The ohio department of medicaid and the ohio department of aging administer the waivers that require a nursing facility level of care. Ohp client agreement to pay for health services this is an agreement between a client and a provider, as defined in oar 4101200000. Ohio department of medicaid joint medicaid oversight committee.
A passport home care consumer can receive needed services as long as the total cost does not exceed 60% of the cost of nursing home care. The passport waiver, restricted to disabled ohioans age 60 and over, will be the focus of this research report. The ohio home care waiver enables people the ability to receive care in their home and community instead of residing in a nursing home, rehabilitation facility or hospital. Wapakoneta, oh 45895 56735651 18886921008 skilled nursing, home health aides, pt, ot, speech therapy senior independence home health care 3003 cisco sidney, oh 45365 9374984680 skilled nursing, home health aides, homemaker services, pt, ot, speech.
If you meet the eligibility requirements for the ohio home care waiver and the financial eligibility for medicaid, you will be enrolled in the waiver and a case manager will be assigned to help develop a personcentered care. The waiver program received approval from the federal centers for medicare and medicaid services cms to begin program operations in july 2006. Passport is designed to keep older adults at home or to help them return home after a nursing facility placement. Assisted living combines a homelike setting with personal support services to provide more intensive care than is available through home care services. Ohio o ohio o ohio o ohio o ohio o ohio o ohio o ohio o ohio o ohio the ohio department of aging is an equal opportunity employer and service provider. Providers must be licensed as a residential care facility by the ohio department of health and certified by the ohio department of aging. Passport has worked for years to give older people alternatives to placement in nursing homes. Passport, providing help at home for ohio seniors, is also referred to as ohio s home and community based medicaid waiver program for older adults. Passport is a statewide medicaid waiver designed to provide an alternative to nursing home care. Passport pre admission screening system providing options and resources today ohios oldest hcbs waiver demonstration waiver in 1984 in two regions of the state approved as a full waiver statewide in 1990 22,000 enrolled.
A waiver services coordinator or a care manager can be contacted at any time at 18553640974, option 5. Refer to the users guide for completing new health partner contract form. A the purpose of this rule is to define the terms used in chapter 516031 of the administrative code governing. They include the ohio home care waiver, passport waiver, and assisted living waiver. Ohio s passport medicaid waiver program helps medicaideligible older ohioans get the longterm services and supports they need to stay in their homes or other community settings, rather than enter nursing homes, when appropriate. Member services 18553640974 toll free services for hearing impaired tty ohio relay 711. Ohio medicaid passport services outline of medicare.
The department administers three different waivers. The answers to the faqs below explain the law s that apply to passport preadmission screening system providing options and resources today beneficiaries. Ohio home care waiver for individuals age 59 or younger passport waiver for individuals age 60 and older assisted living waiver for individuals age 21 or older mycare waiver for individuals age 18 or older who receive both medicaid and medicare the mycare waiver is limited to individuals that reside in the following counties. Passport administrative structure program operations for passport are divided between the ohio department of. Signature of individual requesting medical assistance or authorized representative date. The medicaid estate recovery program, also called mer, is a program through the ohio department of medicaid. The ohio department of medicaid is requesting approval from the centers for medicare and. As one of wraaas flagship services, passport strives to ensure the opportunity for independent living is available to every elderly individual. Seniors are able to live a higher quality of life, as this program provides them with care services and other benefits to promote independence.
Signature of individual requesting medical assistance or authorized representative. The information contained in this website is for reference purposes only. Programs and resources to help ohioans of any age be active, contribute and make healthy choices. Ohio home care western reserve area agency on aging. Medicaid waivers 101 thursday, april 30, 2015 1 john mccarthy, director bonnie k. The ohio medicaid passport waiver program allows seniors that require a nursing facility level of care to remain living at home, or the home of a family member, and receive care in those locations. I am writing in response to the ohio department of education s ode request on november 20, 2017, and amended on january 24, 2018, for a waiver of section l l l lb2dii of the elementary and secondary education act of 1965 esea, as amended by the every student. The program allows the ohio attorney general to recover from the. Mycare ohio is a new managed care program designed for ohioans who receive both medicaid and medicare benefits. A rates determined under this rule shall not exceed the maximum allowable rates for passport services in appendix a to rule 5160106.
Date max fee end date pa pt512 enhanced adult day service 15 minutes maxfee wvr 1. Call tollfree 18662435678 to contact the area agency on aging serving your community for details on how to apply. Services provided on a nondiscriminatory basis homedelivered meals. Passport hcbs waiver provider initial and ongoing certification. Filter resources from this section using specific keywords. Without the ohio home care waiver, these individuals. The ohio home care waiver allows individuals with physical disabilities and unstable medical conditions to receive care in their homes and communities instead of nursing facilities, hospitals or rehabilitation facilities. It is ohios inhome alternative to nursing home care. We recommend you make a photocopy of all materials for your records and send the application via certified mail with return receipt.
The amount of reserved capacity is based on the projected number of currently enrolled ohio home care waiver oh. To find out if assisted living is a good option for you, contact your passport administrative agency. You, or someone acting on your behalf, may request an application be mailed to be completed and returned to. Providing an alternative to nursing home care passport.
Mho2184 1117 1 waiver services billing guide when billing molina healthcare for waiver services, providers need to use the appropriate procedurehcpcs code and modifier combination based on the waiver of origin of the member. The waiver is administered by the ohio department of aging through its regional network of passport administrative agencies. Request additional information for you or a loved one here. The longterm care consumer guide is an online tool that can help you find and compare nursing and residential care facilities, including assisted living, in your area. The purpose of this rule is to describe the methods used to determine provider rates for the passport program. Assisted living waiver program provider certification guide 4 application packet checklist the application packet you submit to your passport administrative agency paa must be complete and accurate.
70 13 1184 1126 162 1411 172 1412 36 508 823 142 1378 77 1430 376 909 1284 37 437 1295 620 283 276 1126 236 635 876 188 512 865 763 1167 250 1034 119 450 1017 1001 467