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home->medicaid

Daily Billing Unit Information

The Daily Rate Application (DRA) is a billing tool allowing for the apportionment of Homemaker/Personal Care (HPC) service costs of IO waiver enrollees living in shared settings.The DRA is an application developed by DODD to work in conjunction with validated cost projection tools (e.g., Franklin County's 2020 instrument) to calculate the appropriate level of reimbursement associated with HPC Daily Billing Units (DBUs). The DRA has been developed to allocate service costs initially calculated with various cost projection tools, and is not meant to be a substitution for them.

Memos and Clarifications:

• All individuals who share HPC services are expected to be entered into the DRA no later than December 31, 2008.


• 7/28/2008 - Daily Billing Unit & Claims Exceeding $403.98
  
  
• 4/25/2008 - DRA Memo: History and General Guidance

Training Resources:

OACB Training

OACB Training

• OACB Training Agenda

• OACB Training Outline

• Simple Ways to Check Your Work

• DRA Presentation (ppt)

• DRA Example (xls)

• DRA FAQ and Answers (updated 10/22/2008)
  
  

• Please note this file will updated periodically please check back

• 2020 Training presentation-zip file (updated 10/22/2008)


• Enhancements to the Daily Rate Application (updated 5/23/08)

For Counties

• DRA county users guide (updated 8/25/08)
  
  
• DRA training presentation for Counties (updated 10/22/08)
  
  
• DRA county XML users guide (updated 9/3/08)

For Providers

The Waiver Billing and the Provider Support Service Units work together to assure that the Ohio Department of Developmental Disabilities provider community is paid in a timely manner. If there is a problem with your billing or reimbursement, please call Provider Support Services at (800) 617-6733 or e-mail Provider Support to get any issues resolved.

When contacting Provider Support Services, please provide your full name, and, agency name (if applicable), your DODD contract billing number, phone number including area code, where you can be reached between 8:00 a.m. and 4:30 p.m., and a brief description of the problem.

• DRA providers users guide(updated 8/25/08)
  
  
• DRA training presentation for Providers (updated 10/22/08)
  
  
• DRA providers XML users guide(updated 9/3/08)

Who to contact for more information:

Email System Innovation and Technical Assistance at
Dailyrate-Support@odmrdd.state.oh.us for program related question

Email Information Technology at
DRA-Support@odmrdd.state.oh.us for technical questions

Waiver Reimbursement

Waiver transition updates

Fall 2007 DRA Training Materials

Adult Foster Care Training Materials

There has been a fundamental change in the way the DODD will reimburse waiver services. To ensure statewide accountability and equity in the delivery of waiver services, the new waiver reimbursement methodology for individuals enrolled on the Individual Options Waiver will include two basic components:

1. A standardized assessment tool which will link individuals to an assigned funding range; and,
2. The establishment of uniform provider rates.
   

For individuals enrolled in the Level One Waiver, the new reimbursement system will include the establishment of uniform provider rates.

In the past, each County Board of DODD had broad administrative responsibilities for providing home and community-based waiver services. Responsibilities included plan development, determination of individual funding levels, negotiation of provider rates, contracting with waiver providers, and the ongoing monitoring of service delivery. This led to statewide inconsistencies in developing individual funding levels and provider rates that often varied from county to county, and in some cases, within individual counties.

The new method for funding waiver services is based on the administration of the Ohio Developmental Disabilities Profile (ODDP), an assessment tool providing standardized score, based on the service needs of the individual. The ODDP also links the assessment of the individual to a funding range. The ODDP allows individuals with similar needs to access comparable waiver services throughout Ohio. An Individual Service Plan (ISP) is then developed. The ISP identifies the actual services needed by the individual, and develops a funding level based on the funding range.

The ODDP and the new provider rates, as established in administrative rule, will be applied universally to all current and new waiver enrollees. This new Waiver Reimbursement System is governed by DODD administrative rule 5123:2-9-06 and became effective July 1, 2005.

In agreement with the federal Centers for Medicare and Medicaid Services (CMS), all existing waiver enrollees must be transitioned to this new waiver reimbursement system by July 1, 2007.

NOTE:  Currently there is a pause to review this system.  Read more about this pause in transition at this link:

• Clarification of "pause the work" as noted in the Pipeline Newsletter

On this website you will find specific information about various aspects of the new waiver reimbursement methodology. Much of it can be downloaded as individual brochures and pamphlets. We will post new and additional information as it becomes available.

A free Adobe Acrobat Reader is required to view and print the .PDF forms on this page.