Ohio Administrative Code Search

...ed waiver service provider 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 provider requirements set forth in Chapters 5160-44 and 5160-45 of the Administrative Code, and Chapter 5160-46 or 5160-58 of the Administrative Code, depending upon the waiver(s) for which the provider is rendering servi...

...ed waiver service provider 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 provider requirements set forth in Chapters 5160-44 and 5160-45 of the Administrative Code, and Chapter 5160-46 or 5160-58 of the Administrative Code, depending upon the waiver(s) for which the provider is rendering servi...

...red waiver service provider will: (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 provider requirements set forth in Chapters 5160-44 and 5160-45 of the Administrative Code, and Chapter 5160-46 or 5160-58 of the Administrative Code, depending upon the waiver(s) for which the provider is rendering servi...

...llowing waiver programs and services: (1) Individual options services, as described in Chapter 5123-9 of the Administrative Code: (a) Homemaker/personal care, participant-directed and provided through an agency; and (b) Waiver nursing, provided through an agency. (2) Level one homemaker/personal care services, participant-directed and provided through an agency, as described in Chapter 512...

...vidual meets the following criteria: (1) The caregiver resides with the individual in the individual's private home or resides with the individual in the caregiver's private home. (2) The individual needs assistance with daily personal care and household support, and assistance with activities needed to promote independence and integration into the community. (3) The individual chooses t...

...vidual meets the following criteria: (1) The caregiver resides with the individual in the individual's private home or resides with the individual in the caregiver's private home. (2) The individual needs assistance with daily personal care and household support, and assistance with activities needed to promote independence and integration into the community. (3) The individual chooses t...

... same meaning as set forth in rule 5160-44-05 of the Administrative Code. (B) "Accreditation commission for health care" or "(ACHC)" is a national organization that evaluates and accredits agencies seeking to participate in the medicare and medicaid programs. For the purpose of providing services to individuals enrolled on an ODM-administered waiver, ACHC-accredited agencies are "otherwis...

... same meaning as set forth in rule 5160-44-05 of the Administrative Code. (B) "Accreditation commission for health care" or "(ACHC)" is a national organization that evaluates and accredits agencies seeking to participate in the medicare and medicaid programs. For the purpose of providing services to individuals enrolled on an ODM-administered waiver, ACHC-accredited agencies are "otherwis...

...tered waiver in accordance with rule 5160-46-02 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 waiver services, and the selection and control over the direction of approved waiver service providers. (A) Individual rights. An individual enrolled in an ODM-administered ...

...tered waiver in accordance with rule 5160-46-02 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 waiver services, and the selection and control over the direction of approved waiver service providers. (A) Individual rights. An individual enrolled in an ODM-administered ...

...tered waiver in accordance with rule 5160-46-02 of the Administrative Code will be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based waiver services, and the selection and control over the direction of approved waiver service providers. (A) Individual rights. An individual enrolled in an ODM-administered ...

... planning process outlined in rule 5160-44-02 of the Administrative Code. (B) For purposes of this rule and rule 5160-45-03.5 of the Administrative Code: (1) Home and community-based services (HCBS) are services available under the "Ohio Home Care" and "MyCare" waiver programs as described in chapters 5160-46 and 5160-58 of the Administrative Code. (2) Individuals are people enrolled on or ...

...ervices, equipment, or supplies that: (1) Are not available through the medicaid state plan benefit or a home and community-based services (HCBS) waiver program; (2) Address an individual's assessed need and are included on the person-centered services plan; and (3) Supplement the medicaid state plan benefit and HCBS waiver services to help the individual successfully remain in the communit...

...web portal in accordance with rule 5160-1-17.2 of the Administrative Code. (C) Upon receipt of the waiver provider application, ODM or its designee shall verify all of the following: (1) The provider applicant submits and meets all applicable ODM-administered waiver provider requirements set forth in Chapters 5160-1, 5160-45 and 5160-46 of the Administrative Code. (2) The provider applicant...

...ation to ODM in accordance with rule 5160-1-17 of the Administrative Code. (C) Upon receipt of the provider application, ODM or its designee shall verify the provider applicant has submitted and meets all applicable ODM-administered waiver provider regulations set forth in Chapters 5160-1, 5160-44, 5160-45, 5160-46, and 5160-58 of the Administrative Code. (D) ODM or its designee shall notify the provider applican...

...l include, but not be limited to: (1) A structural review of compliance with all ODM-administered waiver provider requirements in accordance with paragraph (B) of this rule. (2) Investigation of provider occurrences in accordance with paragraph (C) of this rule. (B) Structural reviews. (1) Medicare-certified and otherwise accredited agency providers as defined in rule 5160-45-01 of the ...

...l include, but not be limited to: (1) A structural review of compliance with all ODM-administered waiver provider requirements in accordance with paragraph (B) of this rule. (2) Investigation of provider occurrences in accordance with paragraph (C) of this rule. (B) Structural reviews. (1) Medicare-certified and otherwise accredited agency providers as defined in rule 5160-45-01 of the ...

...7.31, 2907.32, 2907.321, 2907.322, 2907.323, 2907.33, 2909.02, 2909.03, 2909.04, 2909.22, 2909.23, 2909.24, 2911.01, 2911.02, 2911.11, 2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.05, 2913.11, 2913.21, 2913.31, 2913.32, 2913.40, 2913.41, 2913.42, 2913.43, 2913.44, 2913.441, 2913.45, 2913.46, 2913.47, 2913.48, 2913.49, 2913.51, 2917.01, 2917.02, 2917.03, 2917.31, 2919.12, 2919.121, 2919.123, 2...

...7.31, 2907.32, 2907.321, 2907.322, 2907.323, 2907.33, 2909.02, 2909.03, 2909.04, 2909.22, 2909.23, 2909.24, 2911.01, 2911.02, 2911.11, 2911.12, 2911.13, 2913.02, 2913.03, 2913.04, 2913.05, 2913.11, 2913.21, 2913.31, 2913.32, 2913.40, 2913.41, 2913.42, 2913.43, 2913.44, 2913.441, 2913.45, 2913.46, 2913.47, 2913.48, 2913.49, 2913.51, 2917.01, 2917.02, 2917.03, 2917.31, 2919.12, 2919.121, 2919.321, 2...

...istered waiver service providers. (1) ODM and its designee shall conduct ongoing monitoring and oversight of ODM-administered waiver service providers to verify that each provider is: (a) Complying with the terms and conditions of its medicaid provider agreement, the ODM-administered waiver program and all applicable federal, state and local laws and regulations. (b) Ensuring the health and wel...

...atter involving a minor); (y) 2907.323 (illegal use of a minor in nudity-oriented material or performance); (z) 2909.22 (soliciting or providing support for act of terrorism); (aa) 2909.23 (making terroristic threats); (bb) 2909.24 (terrorism); (cc) 2913.40 (medicaid fraud); (dd) If related to another offense under paragraph (C)(1) of this rule, 2923.01 (conspiracy), 2923.02 (at...

...atter involving a minor); (y) 2907.323 (illegal use of a minor in nudity-oriented material or performance); (z) 2909.22 (soliciting or providing support for act of terrorism); (aa) 2909.23 (making terroristic threats); (bb) 2909.24 (terrorism); (cc) 2913.40 (medicaid fraud); (dd) If related to another offense under paragraph (C)(1) of this rule, 2923.01 (conspiracy), 2923.02 (at...

...ll of the following requirements: (1) Be between the ages of birth through age fifty-nine. (2) Be determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-6 of the Administrative Code.; (3) Participate in an initial assessment to determine if the individual has needs that can be met through the Ohio home care waiver program. (4) Be determined to have a nursing ...

...ll of the following requirements: (1) Be between the ages of birth through age fifty-nine. (2) Be determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-6 of the Administrative Code. (3) Participate in an initial assessment to determine if the individual has needs that can be met through the Ohio home care waiver program. (4) Be determined to have a nursing ...

...s all of the following criteria: (1) The individual is between the ages of birth through age fifty-nine years. (2) The individual is determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-6 of the Administrative Code. (3) The individual participates in an in-person initial comprehensive assessment to determine if the individual has needs that can be met throug...