The Centers for Medicare & Medicaid Services (CMS) is the federal agency that provides health coverage to more than 160 million through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. CMS works in partnership with the entire health care community to improve quality, equity and outcomes in the health care system. cms.gov

CMS Home Health Agency Center |  cms.gov/center/hha

Billing and Payment Policies (2/21/2025) | Medicare Claims Processing Manual (pdf)

Regulations (12/21/2023)  |  Medicare Benefit Policy Manual Chapter 7 (pdf)

State Operations Manual (SOM, 4/12/2024) | SOM Appendix B – Guidance to Surveyors: Home Health Agencies (pdf)

Conditions of Participation (COPs) on Govregs.com |  Title 42 Chapter IV-I3 Part 484 Home Health Services

Medicare Learning Network (MLN)  |  Publications & Multimedia

Medicare Fraud & Abuse (2021)  |  Medicare Fraud & Abuse: Prevent, Detect, Report (pdf)

The CMS Innovation Center develops and tests health care payment and service delivery models to improve patient care, lower costs, and align payment systems to promote patient-centered practices.

Beneficiary Rights and Protections Notices  |  FFS HHCCN  |  HHAs are responsible for issuing the following beneficiary rights and protections notices to Original Medicare (fee for service – FFS) beneficiaries when notice is required: Home Health Change of Care Notice (HHCCN) (ZIP), Advance Beneficiary Notice of Noncoverage (ABN), Notice of Medicare Non-coverage (NOMNC), Detailed Explanation of Non-coverage (DENC).

Home Health Quality Reporting Program  | Your starting point for all resources, recent news, and updates pertinent to the Home Health Quality Reporting Program.

Home Health Quality Reporting Training  |  CMS has many sources of information about Home Health Quality Reporting Program (HHQRP) for stakeholders including:  Training Materials, Training Q&As, and Special Open Door Forum (SODF) Presentations.

Ohio Department of Medicaid  |  medicaid.ohio.gov

Ohio Department of Medicaid Managed Care  |  medicaid.ohio.gov/provider/ManagedCare

Ohio Area Agencies on Aging  |  aging.ohio.gov

ODM Electronic Visit Verification  |  medicaid.ohio.gov/resources-for-providers/special-programs-and-initiatives/electronic-visit-verification

Ohio Department of Health  |  odh.ohio.gov

Ohio Department of Health Home Health Agency Licensure  |   odh.ohio.gov/know-our-programs/home-health-agencies/home-health-agency-licensure

Register of Ohio Rules  |  registerofohio.state.oh.us/rules/search

Ohio Department of Job and Family Services Help Center  |  jfs.ohio.gov/help-center/help-center-sa

Bureau of Workers Compensation (BWC)  |  info.bwc.ohio.gov

Ohio Board of Nursing  |  nursing.ohio.gov

Ohio Department of Insurance  |  insurance.ohio.gov

Ohio Environmental Protection Agency  |  epa.ohio.gov

Ohio Department of Developmental Disabilities  |  dodd.ohio.gov

Ohio Occupational Therapy and Physical Therapy Board  |   otptat.ohio.gov

Ohio State Board of Pharmacy  |  pharmacy.ohio.gov

Ohio Board of Speech Language Pathology and Audiology  |  shp.ohio.gov

Counselor Social Worker & Marriage and Family Therapist Board  |  cswmft.ohio.gov

Ohio Bureau of Criminal Investigation  |  ohioattorneygeneral.gov

Ohio Secretary of State  |  ohiosos.gov  |  Search by Business Name

The Ohio Department of Aging designates planning and service areas for the state and designates an area agency on aging to serve each area. Visit aging.ohio.gov for locations, contact info, and counties covered by each agency.

• Region 1, Council on Aging of Southwestern Ohio  |  Butler, Clermont, Clinton, Hamilton, & Warren counties  |  help4seniors.org
• Region 2, Area Agency on Aging PSA 2 (West Central Ohio)  |  Champaign, Clark, Darke, Greene, Logan, Miami, Montgomery, Preble, & Shelby counties  |  info4seniors.org
• Region 3, Area Agency on Aging 3 (Lower Northwestern Ohio)  |  Allen, Auglaize, Hancock, Hardin, Mercer, Putnam, & Van Wert counties  |  aaa3.org
• Region 4, Area Office on Aging of Northwestern Ohio  |  Defiance, Erie, Fulton, Henry, Lucas, Ottawa, Paulding, Sandusky, Williams, & Wood counties  |  areaofficeonaging.com
• Region 5, Ohio District 5 Area Agency on Aging (North Central Ohio)  |  Ashland, Crawford, Huron, Knox, Marion, Morrow, Richland, Seneca, & Wyandot counties  |  aaa5ohio.org
• Region 6, Central Ohio Area Agency on Aging  |  Delaware, Fairfield, Fayette, Franklin, Licking, Madison, Pickaway, & Union counties  |  coaaa.org
• Region 7, Area Agency on Aging District 7 (Southern Ohio)  |  Adams, Brown, Gallia, Highland, Jackson, Lawrence, Pike, Ross, Scioto, & Vinton counties  |  aaa7.org
• Region 8, Buckeye Hills Regional Council: Aging & Disability (Southeastern Ohio)  |  Athens, Hocking, Meigs, Monroe, Morgan, Noble, Perry, & Washington counties  |  buckeyehills.org
• Region 9, Area Agency on Aging Region 9 (East Central Ohio)  |  Belmont, Carroll, Coshocton, Guernsey, Harrison, Holmes, Jefferson, Muskingum, & Tuscarawas counties  |  aaa9.org
• Region 10A, Western Reserve Area Agency on Aging (Eastern Lakefront Area)  |  Cuyahoga, Geauga, Lake, Lorain, & Medina counties  |  areaagingsolutions.org
• Region 10B, Direction Home Akron Canton Area Agency on Aging and Disabilities  |  Portage, Stark, Summit, & Wayne counties  |  dhad.org
• Region 11, Direction Home of Eastern Ohio  |  Ashtabula, Columbiana, Mahoning, & Trumbull counties  |  dheo.org

The Occupational Safety and Health Administration is part of the United States Department of Labor. OSHA’s mission is to assure America’s workers have safe and healthful working conditions free from unlawful retaliation.

Ohio Area Offices are located in Cincinnati, Cleveland, Columbus, and Toledo. Visit this page for addresses and contact information.

There are several official sites that contain detailed provider information and ratings. While aimed at health care consumers, these sites serve as useful tools for agencies to ensure their online profile is correct, and have visibility on neighboring providers.

Care Compare  |  Medicare.gov Provider Search Portal |  You can use this tool to find and compare different types of Medicare providers (like physicians, hospitals, nursing homes, and others). Use our maps and filters to help you identify providers that are right for you.

OCHCH  |  Home Care & Hospice Resource Directory  |  Are you looking for a care provider in your area? Are you a business in need of essential services? This directory, powered by OCHCH Members, is a free, searchable resource to help you identify the connections you need.

The HIPAA Security Rule establishes national standards to protect individuals’ electronic protected health information that is created, received, used, or maintained by a covered entity or its business associate. The Security Rule requires implementation of appropriate administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and availability of electronic protected health information.

HIPAA Homepage  |  HHS.gov/HIPAA  |  The main jumping off point for all things HIPAA.

The Security Rule  |  HIPAA for Professionals/Security  |  Updates and resources specific to the Security Rule for professional use.

Security Risk Assessment Tool  |  HealthIT.gov  |  The Office of the National Coordinator for Health IT (ONC), in collaboration with the HHS Office for Civil Rights (OCR), developed a downloadable Security Risk Assessment (SRA) Tool to help guide you through the process. The tool is designed to help healthcare providers conduct a security risk assessment as required by the HIPAA Security Rule. The target audience of this tool is medium and small providers; thus, use of this tool may not be appropriate for larger organizations.

OCR’s HIPAA Audit Program  |  Compliance & Enforcement  |  The Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) requires HHS to periodically audit covered entities and business associates for their compliance with the requirements of HIPAA.

Outcome and Assessment Information Set (OASIS)

CMS OASIS Q&As – Archived pdfs of CMS question & answer sessions dating back at least one year.

CMS OASIS Data Sets – Downloadable data sets from CMS, recent and archived.

CMS OASIS User Manuals – Downloadable manuals and references from CMS, recent and archived.

ODH OASIS Training Videos – Collected training videos produced by Ohio Department of Health for provider education.

As a Medicare Administrative Contractor (MAC), Palmetto GBA (Government Benefits Administrator) is one of the nation’s largest providers of high volume claims and transaction processing, contact center operations, and technical services.

Jurisdiction M Home Health and Hospice Medicare Administrative Contractor (MAC)  |  Home Health and Hospice providers in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and Texas.

Local Coverage Determinations (LCDs)  |  Select “Active” for those now in effect.

New Agency Enrollment  |  Provider Enrollment in Jurisdiction M HHH  |  Your hub for enrolling as a Medicare Provider.

Community Health Accreditation Program (CHAP)  |  chapinc.org  |  CHAP is an independent, non-profit, accrediting body for home and community-based healthcare organizations. CHAP is a CMS (Centers for Medicare & Medicaid Services) approved accreditor. CHAP accreditation helps agencies have processes to ensure ongoing quality. OCHCH members are eligible for special savings with CHAP. Learn more

The following are links to regulations regarding background checks as well as seven essential databases.

Ohio Department of Aging  |  Chapter 173-9, Criminal Records Check  |  Ohio Administrative Code regarding background checks for paid direct-care positions.

Ohio Department of Developmental Disabilities  |  Rule 5123-2-02 | Background Investigations for Employment  |  This rule establishes standards for conducting background investigations on persons employed or seeking employment in Ohio’s service delivery system for individuals with developmental disabilities.

Ohio Department of Health  |  Chapter 3701-60  |  Ohio Administrative Code specific to Home Health Agencies.

Ohio Department of Medicaid  |  Rule 5160-45-07 | ODM-administered waiver programs: criminal records checks involving agency providers.

The following are links to organizations supporting health care providers in Ohio.

Ohio Council for Home Care & Hospice (OCHCH), Columbus, OH  |  ochch.org

Ohio Community at Home Network (OCHN), Columbus, OH  |  theochn.org

National Alliance for Care at Home, Washington, DC  |  allianceforcareathome.org

American Nurses Association, Silver Spring, MD  |  nursingworld.org

Home Care Association of America, Washington, DC  |  hcaoa.org

American Association for Homecare (AAHomecare), Arlington, VA  |  aahomecare.org

National League for Nursing, Washington, DC  |  nln.org

National Association of Social Workers Ohio Chapter (NASW), Worthington, OH  |  naswoh.org

Ohio Association of Area Agencies on Aging (o4a), Columbus, OH  |  ohioaging.org

Ohio Association of Medical Equipment Services (OAMES), Westerville, OH  |  oames.org

Ohio Health Information Management Association (OHIMA), Gahanna, OH  |  ohima.org

Ohio Hospital Association (OHA), Columbus, OH  |  ohiohospitals.org

Ohio Nurses Association (ONA), Columbus, OH  |  ohnurses.org

Ohio Physical Therapy Association (OPTA), Westerville, OH  |  ohiopt.org

Ohio State Medical Association (OSMA), Columbus, OH  |  osma.org