173-43-04 Time frames.

This rule sets forth the time frames in which the program administrator shall provide a long-term care consultation.

(A) The program administrator shall complete every long-term care consultation no later than five calendar days after it receives a request for the long-term care consultation, unless the program administrator has an exemption from the five-day time frame under paragraph (B) of this rule.

(B) Exemptions:

(1) If an individual has applied for medicaid coverage, the program administrator shall complete the long-term care consultation in accordance with the applicable time frame for providing a face-to-face level-of-care determination .

(2) An individual (or the individual's representative) may request that the program administrator provide a long-term care consultation before or after the date required under paragraph (A) of this rule. In such cases, the program administrator shall provide the long-term care consultation at a time that is mutually agreed-upon between the individual (or the individual's representative) and the program administrator.

(3) If the program administrator cannot complete the long-term care consultation before the date required under paragraph (A) of this rule, the program administrator shall provide the long-term care consultation as soon as practicable.

Effective: 12/19/2013
R.C. 119.032 review dates: 07/05/2017
Promulgated Under: 119.03
Statutory Authority: 173.01 , 173.02 , 173.42
Rule Amplifies: 173.42
Prior Effective Dates: 06/30/2007, 07/05/2012