(A) "Covered core services" FQHCs are those:
(1) Medical services furnished by a physician, physician assistant, or advanced practice nurse (as described in rules 5101:3-8-20 to 5101:3-8-23 of the Administrative Code, except for an advanced practice nurse providing services relating to mental health services as defined in paragraph (B)(8) of this rule). The services must be within the scope of practice of his or her profession under state law. There must be a written agreement between the FQHC and the health professional stating that he or she will be paid by the FQHC for such services.
(2) Services and supplies furnished as an incident to professional services furnished by a physician, physician assistant, or advanced practice nurse.
(3) Visiting nurse services if:
(a) The service site is located in an area in which the United States secretary of health and human services has determined that there is a shortage of home health agencies;
(b) The services are furnished by a registered nurse, a licensed practical nurse employed by, or otherwise compensated for the services by, the FQHC;
(c) The services are furnished to a homebound individual; and
(d) The services are furnished under a written plan of treatment that is established and reviewed at least every sixty days by a supervising physician of the FQHC or that is established by a physician, physician assistant, or advanced practice nurse and reviewed at least every sixty days by a supervising physician of the FQHC and signed by the physician, physician assistant, or advanced practice nurse or supervising physician.
(B) "Covered noncore services" for FQHCs are those services, other than core services, that include the following:
(1) Physical therapy services;
(2) Speech pathology and audiology services;
(3) Dental services;
(4) Podiatry services;
(5) Optometric and/or optician services;
(6) Chiropractic services;
(7) Transportation services; and,
(8) Mental health services in accordance with the limitations specified in rule 5101:3-28-03 of the Administrative Code.
(C) Services listed in paragraph (C) of rule 5101:3-28-04 of the Administrative Code are not FQHC covered services. FQHCs shall bill the department for these services in accordance with paragraph (C) of rule 5101:3-28-04 of the Administrative Code.
R.C. 119.032 review dates: 03/09/2006 and 07/01/2011
Promulgated Under: 119.03
Statutory Authority: 5111.02
Rule Amplifies: 5111.01 , 5111.02 , 5111.021
Prior Effective Dates: 4/10/91, 3/1/02