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Ohio Laws and Rules
(A) The purpose of this rule is to set forth the qualifications to become and the requirements for a medicaid school program (MSP) provider.
(B) An MSP provider shall:
(1) Be one of the following:
(a) Local education agency (LEA) city school district, local school district, exempted village school district as defined in sections 3311.01 to 3311.04 of the Revised Code;
(b) State school for the deaf as defined by section 3325.01 of the Revised Code;
(c) State school for the blind as defined by section 3325.01 of the Revised Code;
(d) Community school as defined by Chapter 3314. of the Revised Code.
(2) Obtain and maintain a current valid medicaid provider agreement in accordance with rule 5101:3-1- 17.2 of the Administrative Code. The medicaid provider agreement shall indicate the services to be provided as well as an attestation of compliance with paragraph (B)(3) of this rule.
(3) Employ or contract for at least one of the following:
(a) Occupational therapist who holds a current, valid license to practice occupational therapy issued under Chapter 4755. of the Revised Code.
(b) Physical therapist who holds a current, valid license to practice physical therapy issued under Chapter 4755. of the Revised Code.
(c) Speech-language pathologist who holds a current, valid license to practice speech-language pathology issued under Chapter 4753. of the Revised Code.
(d) Audiologist who holds a current, valid license to practice audiology issued under Chapter 4753. of the Revised Code.
(e) Licensed clinical counselor or licensed counselor who holds a current, valid license to practice professional counseling issued under Chapter 4757. of the Revised Code.
(f) Licensed psychologist or licensed school psychologist who holds a current, valid license to practice psychology or school psychology issued under Chapter 4732. of the Revised Code or under rule 3301-24-05 of the Administrative Code.
(g) Licensed independent social worker or social worker who holds a current, valid license to practice social work issued under Chapter 4757. of the Revised Code.
(h) Licensed registered nurse who holds a current, valid license to practice nursing issued under Chapter 4723. of the Revised Code.
(C) An MSP provider shall ensure all employees and contractors who have in-person contact with consumers for the provision of services undergo and successfully complete criminal records checks pursuant to rules adopted under section 5111.032 of the Revised Code.
(D) An MSP provider shall provide services in accordance with rules 5101:3-35-05 and 5101:3-35-06 of the Administrative Code.
(E) An MSP provider shall submit claims in accordance with rule 5101:3-35-04 of the Administrative Code to receive reimbursement for the provision of services.
(F) An MSP provider shall comply with the following for cost reporting and cost reconciliation purposes:
(1) Participate in the random moment time study (RMTS), designed to document the level of effort of MSP providers on a state-wide basis, in compliance with the applicable RMTS guide provided by the Ohio department of education (ODE).
(2) Submit a December count of special education students.
(3) Prepare a cost report in accordance with paragraph (K)(2) of rule 5101:3-35-04 of the Administrative Code.
(4) Contract with an authorized entity to perform an agreed upon procedures review of the cost report and to document adjustments to the cost report, in accordance with paragraph (K)(2) of rule 5101:3-35-04 of the Administrative Code.
(5) Adhere to all applicable rules, including, but not limited to 45 C.F.R. 92, dated October 1, 2007, Revised Code, Administrative Code, CMS Publication 15-1, and provisions outlined in the cost report instructions.
Effective: 10/15/2009
R.C. 119.032 review dates: 07/30/2009 and 10/01/2014
Promulgated Under: 119.03
Statutory Authority: 5111.02
Rule Amplifies: 5111.02
Prior Effective Dates: 11/26/08 (Emer.), 3/2/09