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Provider Compliance

The DODD Office of Provider Standards and Review is responsible for conducting provider compliance reviews of certified Individual Options and Level One waiver providers. The rule governing provider compliance reviews is found in Ohio Administrative Code Section 5123:2-9-08 - "Compliance Reviews of Certified HCBS Waiver Providers". According to this rule, DODD or county boards must review certified providers once during the term of their certification, but at least once every five years.

The county boards will conduct a portion of the required compliance reviews during the five-year review period. DODD will coordinate the completion of these provider compliance reviews with each county board.

  • There are two types of compliance reviews outlined in the rule:
  • Regular reviews must be completed at least once every five years for certified providers billing for IO and/or Level One waiver services.

Special reviews include "look-behind" reviews, by the Department, of reviews completed by county boards as well as additional reviews conducted as a result of a complaint or Major Unusual Incident.

The provider is furnished with a copy of the Compliance Review report. If deficiencies are identified, a Plan of Compliance is required from the provider. The provider has the option to appeal deficiencies outlined in the Compliance Review report. Substantial deficiencies that result in a risk to health and safety or a pattern of non-compliance with applicable requirements, may result in the suspension or revocation of a provider's certification.

If you have questions or for more information, call Kelly Miller at (614) 728-2520 or email kelly.miller@dmr.state.oh.us .

General Compliance Documents

Pre-Review Documents

Individual Options Waiver Provider Review Documents

Level One Waiver Provider Review Documents

Post Review Documents