Ohio Administrative Code Search

...(DODD) in accordance with sections 5166.02 and 5166.23 of the Revised Code. (B) The DODD is responsible for the daily administration of certain components of the medicaid program, to include HCBS, pursuant to an interagency agreement with the Ohio department of medicaid (ODM) in accordance with sections 5162.35 and 5166.21 of the Revised Code. (C) Payment for SELF waiver services will not exceed...

...vices program pursuant to sections 5166.20 and 5166.02 of the Revised Code. (1) The level one waiver program provides necessary waiver services to individuals of any age who meet the criteria for a developmental disabilities level of care in accordance with rule 5123-8-01 of the Administrative Code, and other eligibility requirements established in this rule. (2) The Ohio department of developm...

...(A) Purpose (1) The Ohio department of developmental disabilities (DODD) is responsible for the daily operation of the level one (L1) waiver which will be administered pursuant to sections 5166.20 and 5166.02 of the Revised Code. (2) DODD operates the L1 waiver program pursuant to an interagency agreement with the Ohio department of medicaid (ODM) in accordance with section 5162.35 of the Revis...

...ntains the definitions used in Chapter 5160-43 of the Administrative Code applicable to the specialized recovery services program. (B) Definitions. (1) "Acknowledgment of responsibility" means the document created between the Ohio department of medicaid (ODM) or its designee and an individual enrolled in the program that identifies the interventions recommended by the recovery manager to remedy risks to the health ...

...ns the definitions used in Chapter 5160-43 of the Administrative Code applicable to the specialized recovery services program. (B) Definitions. (1) "Adult Needs and Strengths Assessment (ANSA)" (8/2021) is an integration information assessment tool for use in the development of individualized person-centered care plans, to monitor outcomes, and to help design and plan systems of care for adults ...

...following definitions apply to Chapter 5160-43 of the Administrative Code: (1) "Adult Needs and Strengths Assessment (ANSA)" (8/2021) is an integration information assessment tool for use in the development of individualized person-centered care plans, to monitor outcomes, and to help design and plan systems of care for adults with behavioral health challenges. (2) "Authorized representative" ...

...ll of the following requirements: (1) Be at least twenty-one years of age; (2) Be determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-5 of the Administrative Code; (3) Have a behavioral health diagnosis, be active on the solid organ or soft tissue waiting list, or diagnosed chronic condition as listed in the appendix to this rule; (4) Participate in an init...

...f they meet all of the following: (1) Be at least twenty-one years of age; (2) Be determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-5 of the Administrative Code; (3) Have a behavioral health diagnosis, be active on the solid organ or soft tissue waiting list, or have a diagnosed chronic condition as listed in qualifying diagnosis appendix which is availabl...

...he program in accordance with rule 5160-43-02 of the Administrative Code shall be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based services (HCBS), and the selection and control over the direction of approved services. (B) An individual enrolled in a specialized recovery services program has the ...

...he program in accordance with rule 5160-43-02 of the Administrative Code shall be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based services (HCBS), and the selection and control over the direction of approved services. (B) An individual enrolled in a specialized recovery services program has ...

...he program in accordance with rule 5160-43-02 of the Administrative Code shall be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based services (HCBS), and the selection and control over the direction of approved services. (B) An individual enrolled in a specialized recovery services program has ...

...nity integrated employment positions. (1) IPS-SE activities include: (a) Benefits planning; (b) Development of a vocational plan; (c) General consultation, including advocacy and building and maintaining relationships with employers; (d) Individualized job supports, including regular contact with the individual's employer(s), family members, guardians, advocates, treatment providers, and other co...

...nity integrated employment positions. (1) IPS-SE activities include: (a) Benefits planning; (b) Development of a vocational plan; (c) General consultation, including advocacy and building and maintaining relationships with employers; (d) Individualized job supports, including regular contact with the individual's employer(s), family members, guardians, advocates, treatment providers, and other co...

...nity integrated employment positions. (1) IPS-SE activities include: (a) Benefits planning; (b) Development of a vocational plan; (c) General consultation, including advocacy and building and maintaining relationships with employers; (d) Individualized job supports, including regular contact with the individual's employer(s), family members, guardians, advocates, treatment providers, and other co...

...services program providers shall: (1) Maintain an active, valid medicaid provider agreement as set forth in rule 5160-1-17.2 of the Administrative Code. (2) Comply with all applicable provider requirements set forth in this chapter of the Administrative Code, including but not limited to: (a) Provider requirements as set forth in rule 5160-43-04 of the Administrative Code; (b) Incident rep...

...services program providers shall: (1) Maintain an active, valid medicaid provider agreement as set forth in rule 5160-1-17.2 of the Administrative Code. (2) Comply with all applicable provider requirements set forth in this chapter of the Administrative Code, including but not limited to: (a) Provider requirements as set forth in rule 5160-43-04 of the Administrative Code; (b) Incident rep...

...services program providers shall: (1) Maintain an active, valid medicaid provider agreement as set forth in rule 5160-1-17.2 of the Administrative Code. (2) Comply with all applicable provider requirements set forth in this chapter of the Administrative Code, including but not limited to: (a) Provider requirements as set forth in rule 5160-43-04 of the Administrative Code; (b) Incident rep...

... and recovery management contractors: (1) ODM and/or its designee (hereafter referred to as ODM) shall conduct ongoing monitoring and oversight of providers and contractors, to verify each provider is: (a) Complying with the terms and conditions of its medicaid provider agreement or contract, the program and all applicable federal, state and local regulations; (b) Ensuring the health and welfar...

... recovery management contractors: (1) ODM and/or its designee (hereafter referred to as ODM) shall conduct ongoing monitoring and oversight of providers and contractors, to verify each provider is: (a) Complying with the terms and conditions of its medicaid provider agreement or contract, the program and all applicable federal, state and local regulations; (b) Ensuring the health and welfar...

...ed for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized placement and support - support...

...ed for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized placement and support - support...

...ed for billing and calculating rates. (1) "Billing unit" as used in column 4 of paragraph (C) of this rule, means a single fixed item, amount of time or measurement. (2) "Unit rate" as used in column 3 of paragraph (C) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for each fifteen minutes of service delivered. (B) Payment rates for individualized placement and support - support...

...B) For the purposes of this rule: (1) "Agency" means an entity certified by the Ohio department of mental health and addiction services under section 5119.36 of the Revised Code. (2) "Chief administrator" means the head of an agency, or his or her designee. (3) "Criminal records check" has the same meaning as in section 109.572 of the Revised Code. (4) "Disqualifying offense" means...

...B) For the purposes of this rule: (1) "Agency" means an entity certified by the Ohio department of mental health and addiction services under section 5119.36 of the Revised Code. (2) "Chief administrator" means the head of an agency, or his or her designee. (3) "Criminal records check" has the same meaning as in section 109.572 of the Revised Code. (4) "Disqualifying offense" means...

...B) For the purposes of this rule: (1) "Agency" means an entity certified by the Ohio department of mental health and addiction services under section 5119.36 of the Revised Code. (2) "Chief administrator" means the head of an agency, or his or her designee. (3) "Criminal records check" has the same meaning as in section 109.572 of the Revised Code. (4) "Disqualifying offense" means...