Rule 5160-35-02 | Qualifications to be a medicaid school program (MSP) provider.
(A) The purpose of this rule is to set forth the qualifications to become a medicaid school program provider (MSP) and processes to be followed by an MSP provider.
(B) An MSP provider:
(1) Is one of the following:
(a) A local education agency (LEA) city school district, local school district, exempted village school district, or any other school district as defined in sections 3311.01 to 3311.04 of the Revised Code;
(b) A state school for the deaf as defined by section 3325.01 of the Revised Code;
(c) A state school for the blind as defined by section 3325.01 of the Revised Code;
(d) A community school as defined by section 3314.01 of the Revised Code.
(2) Is an eligible medicaid provider as defined in rule 5160-1-17 of the Administrative Code.
(3) Will employ or contract for at least one of the following:
(a) Occupational therapist as defined in Chapter 4755. of the Revised Code.
(b) Physical therapist as defined in Chapter 4755. of the Revised Code.
(c) Speech-language pathologist as defined in ,-Chapter 4753. of the Revised Code.
(d) Audiologist as defined in ,Chapter 4753. of the Revised Code.
(e) Professional clinical counselor or professional counselor as defined in Chapter 4757. of the Revised Code.
(f) Psychologist or school psychologist as defined in Chapter 4732. of the Revised Code or in rule 3301-24-05 of the Administrative Code.
(g) Independent social worker or social worker as defined in Chapter 4757. of the Revised Code.
(h) Independent marriage and family therapist or marriage and family therapist as defined in Chapter 4757. of the Revised Code;
(i) Independent chemical dependency counselor or chemical dependency counselor II or III as defined in Chapter 4758. of the Revised Code;
(j) Registered nurse as defined in Chapter 4723. of the Revised Code.
(k) Clinical nurse specialist as defined in Chapter 4723. of the Revised Code;
(l) Nurse practitioner as defined in Chapter 4723. of the Revised Code;
(m) Physician assistant as defined in Chapter 4730. of the Revised Code.
(C) An MSP provider will ensure all employees and contractors who have in-person or virtual contact with consumers for the provision of face-to-face or telehealth services undergo and successfully complete criminal records checks pursuant to rules adopted under section 5164.34 of the Revised Code.
(D) An MSP provider is obligated to provide services in accordance with rules 5160-35-05, 5160-35-06, and 5160-35-07 of the Administrative Code.
(E) An MSP provider is obligated to submit claims in accordance with rule 5160-35-04 of the Administrative Code to receive reimbursement for the provision of services.
(F) An MSP provider will maintain documentation of services delivered.
(G) An MSP provider is obligated to comply with the following for cost reporting and cost reconciliation purposes:
(1) Participate in all random moment time studies (RMTS) as defined in rule 5160-35-01 of the Administrative Code .
(2) Submit the federal child count of special education students as defined in section 3301.011 of the Revised Code.
(3) Prepare a cost report in accordance with rule 5160-35-04 of the Administrative Code.
(4) Contract with an independent certified public accountant or firm 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 5160-35-04 of the Administrative Code.
(5) An MSP provider delivers and documents services in accordance with all state and federal laws .
Last updated January 1, 2026 at 12:00 AM
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