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Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation

OhioregulationOhio Department of Medicaid (ODM)· effective 2024-01-01

What this rule requires your agency to do

  • 1Providers must maintain and retain all documentation of services delivered each visit, including tasks performed, date/location, start and end times, and signatures of the provider and individual/authorized representative.(Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation)
  • 2Providers must maintain an active, valid Medicaid provider agreement and comply with provider requirements in Chapters 5160-44, 5160-45, and 5160-46 or 5160-58.(Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation)
  • 3Providers must successfully complete ODM-mandated new provider training within ninety days after their Medicaid enrollment date.(Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation)
  • 4Providers must notify ODM or its designee within twenty-four hours of issues affecting service delivery, and provide at least thirty calendar days' written notice (ten days in specified circumstances) before terminating services.(Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation)
  • 5Providers of nursing, personal care, and home care attendant services must verify service delivery using an ODM-approved electronic visit verification (EVV) system per rule 5160-1-40.(Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation)
  • 6Non-agency providers must annually submit an ODM-approved affidavit stating they paid applicable federal, state, and local income and employment taxes.(Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation)
  • 7Upon entering the provider agreement and annually thereafter, all providers and employees with direct contact must acknowledge in writing they reviewed rule 5160-44-05 on incident management.(Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation)
  • 8Providers must retain all records of service delivery and billing for six years after the date of receipt of payment based on those records, or until any initiated audit is completed, whichever is longer.(Rule 5160-44-31 | ODM-administered waiver programs: provider conditions of participation)

Applies to: cross-cutting

Sets the baseline conditions of participation for all ODM-administered waiver providers, covering provider agreement, training, documentation, record retention, EVV, and prohibited conduct.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.