Chapter 3701-45 Ohio Hearing Aid Assistance Program

3701-45-01 Ohio hearing aid assistance program definitions.

(A) "Audiologist" means an individual authorized under section 4753.07 of the Revised Code to practice audiology.

(B) "Audiology/Hearing Services" includes evaluations, hearing aid selection, preparation, dispensing and orientation, fabricating ear molds; and hearing aid adjustments made within the trial period.

(C) "BCMH" means the "children with medical handicaps program" formerly known as the bureau for children with medical handicap.

(D) "Department" means the Ohio department of health.

(E) "Director" means the director of health or designee.

(F) "Eligible child" means a child from birth up to age twenty-one with a permanent hearing loss who is a resident of Ohio.

(G) "Eligible family" means the family of the eligible child who meets the income criteria for assistance through the Ohio hearing aid assistance program.

(H) "Federal poverty guidelines" means a minimum amount of income that a family, based on the number of family members, needs for food, clothing, shelter, and other necessities, as determined annually by the federal government.

(I) "Hearing Aid Dealer and Fitter" means an individual authorized under section 4747.04 of the Revised Code to practice dealing in or fitting of hearing aids.

(J) "Income" means a family's adjusted gross income based upon their most recent federal income tax return.

(K) "Program administrator" means an individual or contractor responsible for managing the planning, implementation, and evaluation of the Ohio hearing aid assistance program.

(L) "Program" means the Ohio hearing aid assistance program, an earmarked program funded by the Ohio legislature, in Section 285.20 of Amended Substitute HB 59 of the 130th General Assembly, to assist families with eligible children under twenty-one years of age with purchasing hearing aids.

Effective: 05/15/2014
R.C. 119.032 review dates: 05/15/2019
Promulgated Under: 119.03
Statutory Authority: Am. Sub. H.B. 59, 130th GA
Rule Amplifies: Am. Sub. H.B. 59, 130th GA

3701-45-02 Ohio hearing aid assistance program.

(A) In administering funds appropriated for the program:

(1) The director may, in his discretion, designate a program administrator, by contract or other means, to accept applications for participation in the program, verify eligibility for the program, and disburse payments.

(2) The director will supervise distribution of funds.

(3) The director shall establish eligibility criteria for participation in the program.

(4) The director shall prescribe the manner and form for applications from eligible families and audiologists for use in the program.

(5) No later than April first the director will issue guidelines for financial eligibility and family co-payment amounts based upon income. The director will also determine the maximum amount for audiology/hearing services that may be charged by an audiologist or hearing aid dealer and fitter participating in the program. The financial eligibility and co-payment amounts can be found at http://www.odh.ohio.gov/odhprograms/cmh/hearaidasst/Hearing%20Aid%20Assistance%20Program

(B) Applications for assistance under this program for eligible children birth to age 18 must be made through an audiologist. Applications for assistance under this program for eligible children eighteen to twenty-one may be made through an audiologist who:

(1) Is licensed with the Ohio board of speech-language pathology and audiology; and

(2) Agrees to abide by all requirements of participation in the program as set forth in rule 3701-45-04 of the Administrative Code.

(C) Families of eligible children ages eighteen to twenty-one may apply for assistance under this program through a hearing aid dealer and fitter who:

(1) Is licensed with Ohio's hearing aid dealers and fitters board;

(2) Is a BCMH approved hearing aid dealer and fitter and;

(3) Agrees to abide by all requirements of participation in the program as set forth in rule 3701-45-04 of the Administrative Code.

(D) The director or administrator shall:

(1) Verify family eligibility for the program based upon the application submitted from the audiologist;

(2) Disburse funds for payment of hearing aids and provider services; and

(3) Maintain administrative records for implementation of the program.

(E) Funds shall be disbursed in the manner set forth in this chapter until all funds have been expended.

Effective: 05/15/2014
R.C. 119.032 review dates: 05/15/2019
Promulgated Under: 119.03
Statutory Authority: Am. Sub. H.B. 59, 130th G.A.
Rule Amplifies: Am. Sub. H.B. 59, 130th G.A.

3701-45-03 Eligibility requirements for financial assistance through the Ohio hearing aid assistance program.

(A) The director, or program administrator, shall apply the requirements prescribed by this rule in determining whether a family and child are eligible for assistance in purchasing hearing aids through the program.

(B) A family is eligible to participate in the program if:

(1) The family and child are Ohio residents;

(2) There is a child diagnosed with permanent hearing loss;

(3) The family's income is at or below four hundred per cent of the federal poverty guidelines;

(4) Without assistance from the program, the family would be unable to obtain hearing aids for the child with a permanent hearing loss; and

(5) The family agrees to pay to the audiologist or the hearing aid dealer and fitter the co-payment amount, based on a sliding scale fee schedule, found at http://www.odh.ohio.gov/odhprograms/cmh/hearaidasst/Hearing%20Aid%20Assistance%20Program as set forth by the director, if required, due to family income level.

(C) In order to determine financial eligibility for the program, a family must do the following:

(1) Complete the prescribed application to be submitted on its behalf by the audiologist or hearing aid dealer and fitter; and

(2) Provide the necessary documents, as set forth in the application to determine family income.

(D) All decisions on family eligibility are final and are not subject to appeal under Chapter 119. of the Revised Code.

Effective: 05/15/2014
R.C. 119.032 review dates: 05/15/2019
Promulgated Under: 119.03
Statutory Authority: Am. Sub. H.B. 59 of the 130th G.A.
Rule Amplifies: Am. Sub. H.B.59ofthe 130th G.A.

3701-45-04 Requirements for audiologists and hearing aid dealers and fitters participating in the Ohio hearing aid assistance program.

(A) An audiologist or hearing aid dealer and fitter requesting financial assistance on behalf of a family shall submit an application package in the manner and format prescribed by the director.

(B) The application package shall minimally include:

(1) An application from the eligible family meeting the requirements set forth in rule 3701-45-03 of the Administrative Code.

(2) A provider form as prescribed by the director that includes the following:

(a) Audiology or hearing aid dealer and fitter practice information;

(b) Specific hearing aid or aids to be purchased;

(c) Audiogram and other diagnostic audiology test results for the child; and

(d) The signature of the audiologist or hearing aid dealer and fitter.

(e) A written statement signed by a licensed physician that states the eligible child's hearing loss has been medically evaluated and the patient may be considered a candidate for a hearing aid. The medical evaluation must have take place within the preceding six months.

(C) Participating audiologists shall:

(1) Follow the standards of audiology pursuant to Chapter 4753. of the Revised Code and agency 4753 of the Administrative Code;

(2) Follow the standards for appropriate clinical practice as outlined in "American Academy of Audiology Clinical Practice Guidelines, Pediatric Amplification," June 2013 issue. This document is available at http://www.audiology.org/resources/documentlibrary/Documents/PediatricAmplificationGuidelines

(3) Charge their usual and customary fees for audiology/hearing services to eligible families;

(4) Accept the program payment plus a co-payment, if any, based upon program guidelines found athttp://www.odh.ohio.gov/odhprograms/cmh/hearaidasst/Hearing%20Aid%20Assistance%20Program as payment in full for the audiology services; and

(5) Agree that any payments made for the cost of treatment, materials, and hearing aids under this program shall be in excess of and secondary to payments of any third-party payor, and therefore any program payments for costs shall be made after all third-party payment sources are exhausted.

(D) Participating hearing aid dealers and fitters shall:

(1) Follow the standards of practice for hearing aid dealers and fitters pursuant to Chapter 4747. of the Revised Code and agency 4747 of the Administrative Code except all eligible families must present a written statement signed by a licensed physician that states that the individual's hearing loss has been medically evaluated and the individual may be considered a candidate for a hearing aid. The medical evaluation must have taken place within the preceding six months.;

(2) Be an approved BCMH provider;

(3) Charge their ususal and customary fees for hearing services to eligible families;

(4) Accept the program payment plus a co-payment, if any, based upon program guidelines found athttp://www.odh.ohio.gov/odhprograms/cmh/hearaidasst/Hearing%20Aid%20Assistance%20Program as payment in full for the services provided to eligible families;

(5) Agree that any payments made for the cost of treatment, materials, and hearing aids under this program shall be in excess of and secondary to payments of any third-party payor, and therefore any program payments for costs shall be made after all third-party payment sources are exhausted.

Effective: 05/15/2014
R.C. 119.032 review dates: 05/15/2019
Promulgated Under: 119.03
Statutory Authority: Am. Sub. H.B. 59 of the 130th G.A.
Rule Amplifies: Am. Sub. H.B.59ofthe 130th G.A.