5101:3-41-08 Free choice of provider requirements for medicaid home and community-based services programs administered by the Ohio department of mental retardation and developmental disabilities.

(A) The Ohio department of mental retardation and developmental disabilities (ODMRDD), through an interagency agreement with the Ohio department of job and family services (ODJFS), acts as the administrative agency for components of the medicaid home and community-based services programs in accordance with 5111.91 of the Revised Code. In accordance with 5111.871 of the Revised Code, the ODMRDD, as the designated administrator, shall promulgate rule(s) to require that recipients of home and community-based services are provided choice of medicaid home and community-based providers consistent with federal free choice of provider requirements set forth in 42 C.F.R. 431.51 (as amended June 14, 2002). Any rule(s) authorized by this rule and promulgated by the ODMRDD are valid only to the extent they are consistent with 42 C.F.R. 431.51 (as amended June 14, 2002). If the rules promulgated by ODMRDD are capable of more than one interpretation, they shall be applied in a manner most consistent with the letter and intent of 42 C.F.R. 431.51 (as amended June 14, 2002).

(B) Rules promulgated by ODMRDD shall establish policies related to the provision of free choice of medicaid home and community-based service providers for each service specified in a recipient’s individual service plan and shall include the following:

(1) The general roles and responsibilities of the county board of mental retardation and developmental disabilities as specified in rule 5123: 2-9-11 of the Administrative Code.

(2) The roles and responsibilities of the county board of MRDD for the assurance of due process and fair hearing rights regarding recipients’ free choice of medicaid home and community-based service providers.

(3) The roles and responsibilities of ODMRDD for monitoring and assuring compliance with recipients’ free choice of medicaid home and community-based service provider requirements.

(C) ODJFS shall conduct periodic monitoring and compliance reviews related to free choice of medicaid home and community-based service providers.

Effective: 07/01/2005

R.C. 119.032 review dates: 07/01/2010

Promulgated Under: 119.03

Statutory Authority: RC 5111.85, 5111.871

Rule Amplifies: RC 5111.85, 5111.871