On July 28, 2017, the new complex care add-on will be added to the Medicaid Services System (MSS). This add-on will apply to Homemaker/Personal Care services for individuals enrolled in the Individual Options Waiver who meet the criteria specified in the revision to Ohio Administrative Code 5123:2-9-30 (F)(5).
The complex care add-on is available for dates of service beginning 9/1/2017.
MSS will require that it be added to the cost projection if the individual qualifies for the add-on based on answers on the current Ohio Developmental Disabilities Profile (ODDP).
MSS will not allow the complex care add-on to be applied for dates the individual’s ODDP does not indicate he/she is eligible.
The additional costs may result in the person requiring a Prior Authorization (PA). If so, please indicate on the PA if the funding level is exceeded solely as a result of the increased costs of the complex care add-on.
As of 7/1/2017 there were about 1,350 individuals statewide on the Individual Options Waiver who qualified for the complex care add-on.
For more details on the complex care add-on, see the proposed revisions to the Homemaker/Personal Care rule:
