New background check requirement for owners of agencies (3/29/16)
As mandated in the 42 CFR 455.410 and 455.434, the Ohio Department of Medicaid (ODM) now requires criminal records checks of individuals associated with organizations enrolling to become Medicaid providers. Applicants will be notified by mail if a background check is required.
The background check is required for home health agencies, durable medical equipment providers, wheelchair van providers, and waiver services organizations. Any individual who is either a managing employee of a Medicaid provider organization or maintains 5 percent or greater direct or indirect ownership interest of a Medicaid provider agency is also subject to a background check.
Background checks must be completed by the Bureau of Criminal Identification and Investigation. An individual that resides outside of Ohio can complete a criminal background check conducted by the FBI. Individuals who have not lived in Ohio for the last five years, must also complete a FBI check
A complete list of BCI WebCheck vendors is available here.
New Requirement for Providers who Order, Refer, or Prescribe Only
Beginning January 2014, providers who are not enrolled with Ohio Medicaid, but order, refer or prescribe items or services for Medicaid beneficiaries will need to enroll with the Ohio Department of Medicaid. Billing providers will be required to list the ordering, referring or prescribing information on their claims, or their claims will be denied in the near future.
Attention Waiver Services Provider Applicants!
Prior to submitting an application, waiver provider should contact the following for enrollment requirements and assistance:
- For the Ohio Home Care Waiver or the Transitions Carve-out waiver (ODM) – Visit: http://ohiohcbs.pcgus.com/index.html for application and enrollment information or contact PCG at (877) 908-1746. Note: Bureau of Criminal identification & Investigation (BCI&I) reports for initial provider enrollments ONLY should be sent to: The Ohio Department of Medicaid, Attention: BCII Coordinator, P.O. Box 183017, Columbus, Ohio 43218-3017