5101:3-8-24 Eligible providers of certified registered nurse anesthetist (CRNA) services.

(A) Any certified registered nurse anesthetist (CRNA) who holds a current, valid certificate of authority issued under, and in accordance with, Ohio law entitling the holder to practice as a nurse anesthetist is eligible to participate in Ohio’s medicaid program and provide covered CRNA services upon the execution of the Ohio medicaid provider agreement.

(B) A CRNA group practice must meet the criteria as a professional group practice as defined in paragraph (C) of rule 5101:3-1-17 of the Administrative Code and is organized for the purpose of providing CRNA services.

(C) A CRNA who is licensed or holds a current certificate, or similar document under another state’s law entitling the holder to practice as a nurse anesthetist, is eligible to participate in Ohio’s medicaid program and provide covered CRNA services as long as the following are met:

(1) The services are rendered to eligible Ohio recipients in the state in which the CRNA is authorized to practice;

(2) The provider of CRNA services has a currently valid provider agreement with the department; and

(3) The provisions in rule 5101:3-1-11 of the Administrative Code addressing out-of-state coverage are met.

(D) A CRNA that meets the criteria set forth in paragraphs (A) to (C)(2) of this rule is entitled to receive an Ohio medicaid legacy number. CRNA services may be billed if the following conditions are met:

(1) The provisions of paragraph (B) or (C) of rule 5101:3-8-25 of the Administrative Code are met; and

(2) The provisions outlined in rule 5101:3-1-17 of the Administrative Code are met.

Effective: 01/01/2008

R.C. 119.032 review dates: 05/15/2007 and 01/01/2013

Promulgated Under: 119.03

Statutory Authority: 5111.02

Rule Amplifies: 5111.01, 5111.02, 4723.41 to 4723.50

Prior Effective Dates: 3/30/95, 6/1/02