Rule 5101:6-2-31 | State hearings: notice of denial of prior authorization for medical or dental services.
When a request for prior authorization for a medical or dental service is denied, the individual and authorized representative will be provided prompt written notice of the decision. Copies will also be sent to the provider and to the local agency.
(A) The notice will contain:
(1) A clear and understandable statement of the action taken and the reasons for it.
(2) Citations of the applicable regulations.
(3) An explanation of the assistance group's right to and the method of obtaining a state hearing.
(4) A telephone number to call about free legal services.
(B) A notice describing the denial of authorization for medical services will be used.
Last updated January 17, 2025 at 4:45 AM
Supplemental Information
Authorized By:
5101.35
Amplifies: 5101.35, 5160.011
Five Year Review Date: 1/17/2030
Prior Effective Dates: 9/1/1976, 4/1/1980, 10/1/1981, 5/1/1982, 7/1/1982, 4/1/1983, 11/1/1983 (Temp.), 12/1/1983, 1/1/1984, 3/1/1984 (Temp.), 6/1/1984, 10/3/1984 (Emer.), 12/22/1984, 4/1/1986, 4/1/1987, 9/1/1987, 7/1/1988 (Emer.), 9/25/1988, 10/1/1989, 2/1/1990, 4/1/1991, 6/1/1993, 11/1/1994, 6/1/2003, 9/1/2008, 2/28/2014, 3/1/2019
Amplifies: 5101.35, 5160.011
Five Year Review Date: 1/17/2030
Prior Effective Dates: 9/1/1976, 4/1/1980, 10/1/1981, 5/1/1982, 7/1/1982, 4/1/1983, 11/1/1983 (Temp.), 12/1/1983, 1/1/1984, 3/1/1984 (Temp.), 6/1/1984, 10/3/1984 (Emer.), 12/22/1984, 4/1/1986, 4/1/1987, 9/1/1987, 7/1/1988 (Emer.), 9/25/1988, 10/1/1989, 2/1/1990, 4/1/1991, 6/1/1993, 11/1/1994, 6/1/2003, 9/1/2008, 2/28/2014, 3/1/2019