What kind of service provider will qualify for certification?
Any individual or agency currently operating and providing the service, or one similar, in the community may apply for certification. An agency must have already procured qualified staff and be providing the service to consumers. In addition, it must have documentation supporting compliance with policy, procedural and documentation requirements of the PASSPORT Conditions of Participation and Service Specifications.
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What are the Conditions of Participation and Service Specifications and how do they apply to the individual applicant?
ODA has established the PASSPORT Conditions of Participation and Service Specifications as the standards by which all PASSPORT services must be delivered. The Conditions of Participation (91kb) apply to all service providers. The Service Specifications define and set the standards for individual services of PASSPORT and apply only to providers of those services.
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Must an applicant be a Medicare Certified Home Health Agency to quality for certification?
Medicare certification as a home health agency is not a requirement of PASSPORT service provider participation. Though the program has a medical component, not all PASSPORT services are medical in nature. However, providers who work cooperatively with PASSPORT to provide RN, PT, OT and ST intermittent home health services must bill traditional Medicaid for reimbursement, as Ohio has determined that these services are reimbursable only when delivered by a Medicare certified home health agency.
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Where and how does an agency apply for participation?
An application packet may be obtained from any PASSPORT Administrative Agency. The completed packet should be submitted directly to the PASSPORT Administrative Agency responsible for the geographic area in which the agency's place of business/service origination is located. If your offices are located outside the state of Ohio, submit the packet to the PASSPORT Administrative Agency responsible for the geographic area in which you propose to furnish services.
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Is a provider limited to serving in only one PASSPORT Administrative Agency?
No. Each applicant is reviewed for certification by the PASSPORT Administrative Agency in which their place of business/service origination is geographically located. Once certified, an agency may expand service delivery to other geographic areas. Agencies can be certified to furnish services in any size area for which they can reasonably meet the qualifications of the Conditions of Participation and Service Specifications.
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Does the agency have to complete another full application to provide services in another PASSPORT Administrative Agency?
No. Once certified to provide services in one PASSPORT Administrative Agency, the agency would complete the Request For Provider Agreement/Expansion form and submit it to each PASSPORT Administrative Agency for which it wishes to offer services.
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Must an agency be or become a traditional Ohio Medicaid service provider to participate in the PASSPORT program?
No. While PASSPORT is a Medicaid waiver program, PASSPORT certification does not make an agency eligible to deliver traditional Medicaid services in Ohio. PASSPORT Medicaid Provider enrollment permits the provider to be reimbursed for PASSPORT waiver services only.
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How does a provider receive PASSPORT Medicaid Reimbursement for services?
Reimbursement for PASSPORT services requires the provider to have a Medicaid provider number that indicates PASSPORT provider status. The PASSPORT provider application packet includes a Medicaid Enrollment application.
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If the applicant is already a provider of traditional Ohio Medicaid services, does it need to apply for another Medicaid number?
Yes. Reimbursement for PASSPORT services requires the provider to have a Medicaid number that has a waiver designation code. The PASSPORT provider application packet includes a Medicaid Enrollment Form. ODJFS will assign the PASSPORT waiver designation code to an existing provider Medicaid number or will assign a new number to the provider to be used exclusively for reimbursement of waiver services.
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What happens if the applicant does not successfully demonstrate compliance with the Conditions of Participation and Service Specifications?
There are key elements of the Conditions of Participation and Service Specifications that are viewed as basic "structural elements." These identify the agency's basic organizational structure, policies, procedures, documentation formats and current service to the community. Development of a quality community provider base is a PASSPORT value. To ensure consumer choice, we have developed technical assistance mechanisms to assist applicants in understanding and complying with the Conditions of Participation and Service Specifications. The PASSPORT Administrative Agency representative will identify areas of non-compliance and provide a timeframe for corrective action.
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What are typical non-compliance findings?
Typical findings are: documentation formats that do not provide for consumer or worker signature, record retention policies that do not meet the six-year PASSPORT requirement, documentation of personnel orientation and training and documentation of volunteer identification and screening. An agency is given a thirty-day period to submit corrective actions to the PASSPORT Administrative Agency, during which you may call upon the PASSPORT Administrative Agency to answer questions. An applicant may also elect to withdraw its application.
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Must an applicant develop a special manual just for PASSPORT services?
No. In reviewing each applicant's materials, the PASSPORT Administrative Agency staff strives first to ascertain if the applicant's current documents and procedures meet the PASSPORT requirements. It is not necessary to "write" a PASSPORT manual. Where certain policies, procedures, or documentation formats do not meet PASSPORT requirements, modification, such as adding space for consumer signature to a form or case management notification to a communication procedure can be accomplished at minimal cost.
An agency may choose to identify PASSPORT individually in certain policies and procedures (e.g., communication to case manager, consumer signature on service delivery documentation, PASSPORT records retained for six years) to ensure staff understanding of elements of PASSPORT service delivery or record retention that vary from existing practices.
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What will the PASSPORT Administrative Agency reviewer expect to "see" or "look at" during the on-site survey/evaluation visit?
The PASSPORT Administrative Agency reviewer will be assessing key elements of the Conditions of Participation and Service Specifications. We recognize that an agency cannot demonstrate compliance with service delivery or certain other compliance requirements until it is actually delivering PASSPORT services. However, basic "structural elements" can be reviewed. Each specific PASSPORT service that the applicant wishes to furnish adds elements to the initial on-site pre certification survey/evaluation. The specific service area requires review or assessment of the elements listed in the Service Specifications of each service, such as documentation of training and skill testing, as well as documentation specific to the service delivered.
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Ohio Department of Aging