EON assists in the waiver administration of Home and Community Based Services (HCBS). These services include: Provider Compliance Review, Compensation, and Free Choice of Provider.
EON completes reviews on behalf of the county boards according to OAC 5123:2-9-08 HCBS Waiver-Compliance reviews of certified HCBS waiver providers.
According to the ODMRDD protocol for monitoring and compliance of HCBS Waiver Providers, “The focus of provider compliance reviews is to verify certified waiver providers are maintaining the standards and qualifications of each waiver service for which the provider is certified.”
There are three types of reviews: a regular review, special review, and look-behind review.
Regular review: A regular review will be scheduled and conducted for all certified providers at least one time every five years in each county that a waiver service is provided. All waiver services for which the provider is certified and has billed will be reviewed. Annually, ODMRDD will identify the providers to be reviewed in each quarter of that year.
Special review: A special review is an unscheduled review that may be conducted as a result of an MUI, or indications that the provider is not maintaining provider certification standards. Only the service affected by the circumstances will be reviewed.
Look-behind review: ODMRDD will review a sample of certified providers reviewed throughout the calendar year to verify the county board conformed to the provider compliance review requirements in OAC 5123:2-9-08.
All protocol tools are available at www.odmrdd.state.oh.us
ll waiver billing is submitted to ODMRDD via their applications portal located at https://odmrdd.state.oh.us/apps/
A security affidavit is required to log onto this portal and is available at this portal. Any questions regarding billing may be directed to ODMRDD Provider Support at Provider.support@odmrdd.state.oh.us or 1-800-617-6733
PAWS – Payment Authorization for Waiver Services
A PAWS authorizes payment to an ODMRDD certified provider. A PAWS is generated when ODMRDD PAWS unit enrolls authorized information provided by NEON. NEON receives the authorized information from the county board as identified in the individual’s Individual Service Plan (ISP).
Licensed facility Room and Board
OAC 5123:2-3-18 specifies how room and board will be calculated for an individual residing in a residential facility. NEON, on behalf of county boards, and the provider enter into a contract to meet this rule requirement. Consumer Resource reports shall be submitted to NEON by the end of each month for the previous month. Payments shall be made by NEON within 30 days of receipt of consumer resource report.
ffective July 1, 2005, OAC 5123:2-9-11 HCBS Waivers – free choice of provider
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A summary of the process is below:
(All steps have defined timelines for completion, unless mutually agreed to be extended)
- Individual reviews website and chooses preliminary providers to be contacted
- Not necessary if individual/parent/guardian have a provider in mind
- Preliminary providers are contacted to determine interest in serving the individual.
- May be done by individual/ parent/guardian or County board designee (SSA or NEON)
- Provider indicates interest and provides information as requested and/or makes themselves available for a meeting
- After meeting, provider indicates continued interest, and then receives information regarding services and supports, after consent from individual/parent/guardian, from County board.
- After receipt of additional information, provider makes determination to serve or not to serve. At this point, provider may request additional information or assessments.
Click here to search for ODMRDD Certified Providers
https://odmrdd.state.oh.us/apps/Internet/pcs_publicdisplay/
PCS_PublicWelcome.aspx
NEON Provider Choice Checklist
Preliminary information
Authorization for the release of information
Authorization to release additional information
NEON Change notice
