3701-44-13 Reconsideration of eligibility and authorization decisions.

(A) The following persons may seek reconsideration of the specified decisions pertaining to the Ryan White home health program:

(1) An individual who has applied for eligibility for benefits and whose application has been denied by the community-based HIV case manager;

(2) An individual or entity that has applied for eligibility as a provider and whose application has been denied by the consortium or consortia program coordinator;

(3) An individual or entity whose eligibility as a recipient or provider has been terminated by the community-based HIV case manager or the director, as applicable; and

(4) An individual or entity that has sought authorization of payment for services from the director and whose request has been denied.

(B) A person seeking reconsideration shall file a written request for reconsideration with the program within thirty days of receipt of the decision. A final appeal to the director may be made within thirty days after the date of mailing the home health program’s decision. The final appeal shall be submitted to the AIDS client resources section of the Ohio department of health. The request shall be accompanied by any written material that the person making the request wishes to present. The director shall provide the person with written notice of his or her decision on reconsideration and the decision shall be final.

R.C. 119.032 review dates: 06/29/2006 and 06/29/2011

Promulgated Under: 119.03

Statutory Authority: 3701.241

Rule Amplifies: 3701.241

Prior Effective Dates: 7/20/2001