Ohio Administrative Code Search

...ing services provided prior to December 14, 1992. (1) Registered nurses and licensed practical nurses who are not employed by a medicare certified, joint commission accredited, or community health accreditation program (CHAP) accredited home health agency, or a home health agency accredited through an organization that has been granted deeming authority by the centers for medicare and medicaid services (CMS) may con...

...services provided prior to December 14, 1992. (1) Registered nurses and licensed practical nurses who are not employed by a home health agency a home health agency certified in accordance with rule 4123-6-02.2 of the Administrative Code may continue to provide authorized services to an injured worker if the services began prior to December 14, 1992. (2) The need for nursing services must be ...

...(A) For purposes of this rule: (1) "Amputee clinic" means an interdisciplinary group of professional providers led by a physician with a specialty in physical medicine and rehabilitation, orthopedic surgery or vascular surgery knowledgeable in the field of prosthetics and physical disabilities, comprised of members that may include a podiatrist, physical therapist, occupational therapist, kinesiotherapist, prosthet...

...t, under the following circumstances: (1) When the claimant has been ordered or authorized to undergo a medical examination outside of the city or community limits where he resides. The claimant shall be reimbursed for travel only if the travel distance exceeds a mileage distance as periodically determined by the bureau. The minimum mileage distance for reimbursement shall be published periodically by the bureau. (...

...t, under the following circumstances: (1) When the injured worker has been ordered or authorized to undergo a medical examination outside of the city or community limits where he resides. The injured worker shall be reimbursed for travel only if the travel distance exceeds forty-five miles round trip. (2) When treatment necessary for the allowed work related condition cannot be obtained within t...

...ease that is compensable under Chapter 4121., 4123., or 4131. of the Revised Code. (B) An employer may establish a bureau certified QHP, that shall comply with the thirteen standards set forth in divisions (A)(1) to (A)(13) of section 4121.442 of the Revised Code, division (P) of section 4121.44 of the Revised Code, and rules 4123-6-53 and 4123-6-54 of the Administrative Code. (C) The bureau is authorized to recert...

...te to the parties of the dispute. (1) If an individual health care provider eligible to be physician of record would be providing the services requested in the dispute, the independent level of professional review shall consist of a peer review conducted by an individual or individuals licensed pursuant to the same section of the Ohio Revised Code as the health care provider who would be providin...

...pursuant to division (A)(9) of section 4121.442 of the Revised Code, the administrator shall require employers and QHPs that participate in the workers' compensation QHP system to report data to be used by the administrator to measure and perform comparison analyses of costs, quality, appropriateness of medical care, and effectiveness of medical care delivered by all components of the workers compensation system. (B...

... promulgated in accordance with section 1347.15 of the Revised Code, the following definitions apply: (A) "Access" as a noun means an opportunity to copy, view, or otherwise perceive whereas "access" as a verb means to copy, view, or otherwise perceive. (B) "Acquisition of a new computer system" means the purchase of a "computer system," as defined in this rule, that is not a computer system curre...

... as defined in division (B) of section 4123.01 of the Revised Code, that either fails to establish or maintain industrial coverage, or fails to make payments of premiums to the state insurance fund, as required by Chapter 4123. of the Revised Code and the rules of the industrial commission and the bureau of workers' compensation, or fails to comply with the requirements for self-insurance under section 4123.35 of the...

...defined in division (B) of section 4123.01 of the Revised Code, that either fails to establish or maintain industrial coverage, or fails to make payments of premiums to the state insurance fund, as set forth by Chapter 4123. of the Revised Code and the rules of the industrial commission and the bureau of workers' compensation, or fails to comply with the requirements for self-insurance under s...

...o the administrator under Chapters 4121., 4123., and 4131. of the Revised Code and the rules adopted by the bureau of workers' compensation for determining employer premium, assessment, or penalty obligations or liabilities, eligibility for alternative premium plans or discount programs, or other employer-related disputes or issues as may be authorized under the workers' compensation statutes ...

...o the administrator under Chapters 4121., 4123., and 4131. of the Revised Code and the rules adopted by the bureau of workers' compensation for determining employer premium, assessment, or penalty obligations or liabilities, eligibility for alternative premium plans or discount programs, or other employer-related disputes or issues as may be authorized under the workers' compensation statutes ...

...o the administrator under Chapters 4121., 4123., and 4131. of the Revised Code and the rules adopted by the bureau of workers' compensation for determining employer premium, assessment, or penalty obligations or liabilities, eligibility for alternative premium plans or discount programs, or other employer-related disputes or issues as may be authorized under the workers' compensation statutes ...

...(A) Chapter 4123-16 of the Administrative Code shall apply to all personal information systems maintained by the bureau unless exempted in paragraph (C) or (D) of this rule. (B) The bureau maintains a personal information system which it deposits or stores in a record center or stores in or has processed by a data center. The bureau does not maintain a personal information system belonging t...

...tion shall be given to the following: (1) The nature and vulnerability of the personal information. (2) The physical facilities where the personal information is maintained or used. (3) The need for the feasibility of keeping personal information in a secure place, considering paragraphs (A)(1) and (A)(2) of this rule, the cost of providing a secure place and the need for access to the place where information is k...

...(A) Private employers. (1) The annual revision of premium rates as provided in division (B) of section 4123.34 of the Revised Code applies to all renewals, reinstatements, and new coverage effective on or after July first of each year, unless otherwise specifically provided. The bureau of workers' compensation may adopt such changes in classification of occupations or industries with respect to t...

...(A) Private employers. (1) The annual revision of premium rates as provided in division (B) of section 4123.34 of the Revised Code shall apply to all renewals, reinstatements and new coverage effective on or after July first of each year, unless otherwise specifically provided. At the same time the bureau of workers' compensation may adopt such changes in classification of occupations or industri...

...(A) Responsibilities. (1) Whenever one employer succeeds another employer in the operation of a business in whole or in part, the successor shall notify the bureau of workers' compensation of the succession. (2) Pursuant to this rule, the bureau will provide to the parties to the transfer of experience the necessary forms and instructions to complete the transfer of the appropriate payrolls ...

...(A) Responsibilities. (1) Whenever one employer succeeds another employer in the operation of a business in whole or in part, the successor shall notify the bureau of the succession. (2) Pursuant to this rule, the bureau shall provide to the parties to the transfer of experience the necessary forms and instructions to complete the transfer of the appropriate payrolls and claims. The bureau shall...

...) Definitions. As used in this rule: (1) "Experience period" means: (a) For private employer policy years commencing on or after July 1, 2016, the oldest four of the latest five completed policy years immediately preceding the beginning of the policy year to which a rate is applicable. (b) For public employer taxing districts policy years commencing on or after January 1, 2016, the oldest four of the last five co...

...) Definitions. As used in this rule: (1) "Eligibility determination date" means the March first immediately preceding the policy year for which the EM is being calculated for private employers, and the September first immediately preceding the policy year for which the EM is being calculated for public employer taxing districts. (2) "Experience modification" or "EM" means the experience modific...

...) Definitions. As used in this rule: (1) "Experience modification" or "EM" means the experience modification as determined under rule 4123-17-03 of the Administrative Code. (2) "Eligibility determination date" means the March first immediately preceding the policy year for which the EM is being calculated for private employers, and the September first immediately preceding the policy year for ...

...) Definitions. As used in this rule: (1) "Experience modification" or "EM" means the experience modification as determined under rule 4123-17-03 of the Administrative Code. (2) "Eligibility determination date" means the March first immediately preceding the policy year for which the EM is being calculated for private employers, and the September first immediately preceding the policy year for ...

...endix to this rule to be effective July 1, 2024. (B) A private employer is eligible for the premium adjustment under this rule provided the private employer is not a professional employer organization as defined in section 4125.01 of the Revised Code, and the private employer is individually experience rated, individually retrospective rated, group retrospective rated, or participating in a deduc...