Ohio - Home Modification Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Ohio Department of Aging (ODA) and the Ohio Department of Medicaid (ODM) certify and enroll contractors to provide Minor Home Modification services under the PASSPORT and Ohio Home Care waivers. This service funds assessed, permitted, and inspected structural changes that make an existing home usable and safe for Medicaid beneficiaries.

Before submitting an application through the Provider Network Management (PNM) module, agency applicants must secure a one million dollar commercial liability policy, obtain an employee dishonesty or property damage bond, and prove the applicant or CEO has maintained continuous Ohio residency for the past five consecutive years.

1. Service Definition and Scope

Minor Home Modification in Ohio encompasses structural changes to a waiver participant's private residence that are necessary to ensure health, welfare, and safety.

The service requires that all modifications be assessed by a qualified professional, properly permitted by local building authorities, and inspected upon completion.

• Service Name: Minor Home Modification
• Funding Authority: PASSPORT Waiver and Ohio Home Care Waiver
• Scope Inclusion: Ramps, grab bars, widened doorways, and accessible bathroom modifications
• Scope Exclusion: General home maintenance, roof repair, or modifications that add square footage
• Requirement: Local building permits must be obtained prior to construction
• Requirement: Post-modification inspection to verify safety and compliance

2. Regulatory and Oversight Agencies

The Ohio Department of Aging (ODA) certifies providers for the PASSPORT waiver, while the Ohio Department of Medicaid (ODM) handles final enrollment and claims processing.

Public Consulting Group (PCG) partners with ODM to provide Provider Network Development and Oversight for HCBS Waiver programs.

• Certifying Agency: Ohio Department of Aging (https://aging.ohio.gov)
• Enrollment Agency: Ohio Department of Medicaid (https://medicaid.ohio.gov)
• Oversight Partner: Public Consulting Group (https://ohiohcbs.pcgus.com)
• Enrollment Portal: Provider Network Management (PNM) Module (https://ohpnm.omes.maximus.com/OH_PNM_PROD/Account/Login.aspx)

3. Gatekeeping Prerequisites: Who Can Even Apply

Ohio does not require a Certificate of Need for Minor Home Modification providers. However, strict business and residency prerequisites block applicants before an application is accepted.

Applicants must prove established residency and secure specific commercial insurance bonds before initiating the certification process.

• Residency Prerequisite: Applicant or CEO must provide evidence of Ohio residency for the last five consecutive years
• Business Registration: Must hold a current registration certificate with the Ohio Secretary of State
• Workers Compensation: Must possess a current certification in good standing with the Ohio Bureau of Workers Compensation
• Network Affiliation: No mandatory managed care affiliation required to apply, but providers must enroll with ODM to contract with MCOs

4. Licensure and Certification Requirements

Providers must apply to the Ohio Department of Aging to be certified as an agency provider for the PASSPORT Medicaid Waiver Program.

The certification process requires uploading specific organizational and financial documentation to prove the agency's capacity to perform structural modifications safely.

• Liability Insurance: Copy of current policy of minimum of one million dollars in commercial liability insurance
• Property Damage Insurance: Copy of current policy for employee dishonesty or property damage to others (warranty, surety, or business services bond)
• Organizational Structure: Copy of a table of organization that includes the full name of each position and indicates lines of authority
• Federal Compliance: Printed and uploaded overview of federal requirements with the HCBS Settings Requirement Form

5. Medicaid Provider Enrollment

After obtaining ODA certification, providers must complete a web-based electronic application through Ohio's Provider Network Management (PNM) module.

Ohio does not accept paper applications, and providers must pay a federal application fee unless they have paid it to another state or Medicare recently.

• Application Portal: PNM Module via OHID
• Application Fee: $688 non-refundable Medicaid application fee per OAC 5160-1-17.8
• Fee Exemption: Waived if paid to Medicare, ODM, or DODD within the past two years (proof required)
• Retroactive Enrollment: Providers can request retroactive enrollment up to 365 days under OAC 5160-1-17.4

6. Staffing, Training and Background Checks

All owners and key personnel must undergo strict criminal background checks at the time of application.

Because contractors enter the homes of vulnerable adults, both state and federal background checks are mandated depending on residency history.

• State Check: BCI criminal record check required for each owner at the time of application
• Federal Check: FBI record check required if the applicant currently lives or has lived outside of Ohio anytime in the past five years
• Submission Routing: All background check results must be sent directly to the Ohio Department of Aging
• Training Requirement: Providers must complete required annual continuing education (CE) via PCG online courses

7. Documentation, Policies and Records

Providers must maintain comprehensive records of all modifications, including initial assessments, building permits, and final inspections.

Tax and business documentation must be kept current and uploaded during the initial application and revalidation phases.

• Tax Documentation: Completed and Signed W-9 form generated during the online application
• Permit Records: Copies of all local building permits obtained for each modification job
• Inspection Records: Signed final inspection approvals from local building authorities
• Setting Compliance: HCBS Settings Requirement Form maintained on file

8. Billing, Rates and Claims

Minor Home Modification services are billed through the ODM Medicaid Information Technology System (MITS) or the newer PNM claims interface.

Services must be prior-authorized by the waiver participant's case manager before any construction begins.

• Prior Authorization: Required from the PASSPORT Administrative Agency (PAA) before work commences
• Billing System: Claims submitted electronically via the PNM module
• Tax Reporting: Only billing providers who receive more than $600 in payments from ODM will receive a 1099
• MCO Billing: Providers must be active in ODM's system to have claims paid by Managed Care Organizations

9. Approval Sequence and Timeline

The approval sequence requires sequential clearance from the Secretary of State, the Department of Aging, and finally the Department of Medicaid.

Processing times vary, but applicants should expect the entire certification and enrollment process to take several months.

• Step 1: Register business with Ohio Secretary of State and obtain BWC certificate
• Step 2: Secure $1M liability insurance and property damage bond
• Step 3: Submit BCI/FBI background checks directly to ODA
• Step 4: Submit ODA certification application and pay $688 fee
• Step 5: Complete ODM enrollment via the PNM module upon ODA approval

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to incomplete documentation or failure to meet the strict residency and insurance prerequisites.

Failure to route background checks directly to the correct agency is a primary cause of application abandonment.

• Denial Reason: Failure to provide acceptable proof of five-year Ohio residency for the applicant or CEO
• Denial Reason: Background check results sent to the provider instead of directly to ODA
• Denial Reason: Missing or insufficient employee dishonesty/property damage bond
• Denial Reason: Failure to pay the $688 application fee or provide proof of recent payment

11. Key Contacts and Resources

Providers should utilize the official state portals and designated oversight contractors for application assistance and policy updates.

Regional PASSPORT Administrative Agencies (PAAs) serve as local contacts for waiver enrollment and service authorization.

• Ohio Department of Aging Provider Certification: https://aging.ohio.gov/agencies-and-service-providers/certification
• Ohio Medicaid Provider Enrollment: https://medicaid.ohio.gov/resources-for-providers/enrollment-and-support
• PNM Login Portal: https://ohpnm.omes.maximus.com/OH_PNM_PROD/Account/Login.aspx
• PCG Provider Network Oversight: https://ohiohcbs.pcgus.com

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