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Rule 5160-45-08 | ODM-administered waiver programs: criminal records checks involving independent providers.

...(A) This rule sets forth the process and requirements for the criminal records checks of independent providers of home and community-based services (HCBS) in Ohio department of medicaid (ODM) -administered waiver programs. (B) For the purposes of this rule, (1) "Anniversary date" means the later of the effective date of the provider agreement relating to the independent provider or sixty day...

Rule 5160-45-08 | ODM-administered waiver programs: criminal records checks involving independent providers.

...(A) This rule sets forth the process and requirements for the criminal records checks of independent providers of home and community-based services (HCBS) in Ohio department of medicaid (ODM) -administered waiver programs. (B) For the purposes of this rule: (1) "Applicant" means a person who has applied for a medicaid provider agreement to provide HCBS as an independent provider under an ODM...

Rule 5160-45-09 | ODM-administered waiver program: program compliance, monitoring and oversight of ODM-administered waiver service providers and ODM-administered waiver program contractors.

...(A) The Ohio department of medicaid (ODM) is responsible for the ongoing monitoring and oversight of all ODM-administered waiver service providers and all ODM-administered waiver contractors in order to assure providers' and contractors' compliance with ODM-administered waiver program requirements. (B) Monitoring and oversight of ODM-administered waiver service providers. (1) ODM and its designe...

Rule 5160-45-09 | ODM-administered waiver program: program compliance, monitoring and oversight of ODM-administered waiver service providers and ODM-administered waiver program contractors.

...(A) The Ohio department of medicaid (ODM) is responsible for the ongoing monitoring and oversight of all ODM-administered waiver service providers and all ODM-administered waiver contractors in order to ensure providers' and contractors' compliance with ODM-administered waiver program requirements. (B) Monitoring and oversight of ODM-administered waiver service providers. (1) ODM and its designee, as applicable, sh...

Rule 5160-45-11 | ODM-administered waiver programs: exclusionary periods for disqualifying offenses; certificates; and pardons.

...(A) Except as set forth in paragraph (H) of this rule, a waiver agency may employ an applicant or continue to employ an employee who has been convicted of or pleaded guilty to an offense listed in paragraph (B)(6) of rule 5160-45-07 of the Administrative Code in a position involving providing home and community-based services (HCBS) to an individual enrolled on an Ohio department of medicaid (ODM)...

Rule 5160-45-11 | ODM-administered waiver programs: exclusionary periods for disqualifying offenses; certificates; and pardons.

...(A) Except as set forth in paragraph (H) of this rule, a waiver agency may employ an applicant or continue to employ an employee who has been convicted of or pleaded guilty to an offense listed in paragraph (B)(6) of rule 5160-45-07 of the Administrative Code in a position involving providing home and community-based services (HCBS) to an individual enrolled on an Ohio department of medicaid (ODM)...

Rule 5160-45-11 | ODM-administered waiver programs: exclusionary periods for disqualifying offenses; certificates; and pardons.

...(A) Except as set forth in paragraph (H) of this rule, a waiver agency may only employ an applicant, or continue to employ an employee, or continue to contract with a subcontractor who has been convicted of or pleaded guilty to an offense listed in divisions (A)(3)(a) to (A)(3)(e) of section 109.572 of the Revised Code in a position providing home and community-based services (HCBS) to an individu...

Rule 5160-46-02 | Ohio home care waiver program: eligibility and enrollment.

...(A) To be eligible for enrollment in the Ohio home care waiver program, an individual must meet all 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 ...

Rule 5160-46-02 | Ohio home care waiver program: eligibility and enrollment.

...(A) To be eligible for enrollment in the Ohio home care waiver program, an individual must meet all 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 t...

Rule 5160-46-02 | Ohio home care waiver program: eligibility and enrollment.

...(A) An individual is eligible for enrollment in the Ohio home care waiver program only if the individual meets 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...

Rule 5160-46-04 | Ohio home care waiver: definitions of the covered services and provider requirements and specifications.

...This rule sets forth definitions of some services covered by the Ohio home care waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administ...

Rule 5160-46-04 | Ohio home care waiver: definitions of the covered services and provider requirements and specifications.

...This rule sets forth definitions of some services covered by the Ohio home care waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administ...

Rule 5160-46-04 | Ohio home care waiver: definitions of the covered services and provider requirements and specifications.

...This rule sets forth definitions of some services covered by the Ohio home care waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administ...

Rule 5160-46-04 | Ohio home care waiver: personal care aide service.

...This rule sets forth the definition of personal care aide services and as well as the provider requirements and specifications for the delivery of the service. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administrative Code. (A) "Personal care aide services" are ...

Rule 5160-46-06 | Ohio home care waiver program: reimbursement rates and billing procedures.

...(A) Definitions of terms used for billing and calculating rates. (1) "Base rate," as used in table A, column 3 of paragraph (B) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for the first thirty-five to sixty minutes of service delivered. (2) "Bid rate," as used in table B, column 3 of paragraph (B) of this rule, means the per job bid rate negotiated between the provider and the...

Rule 5160-46-06 | Ohio home care waiver program: reimbursement rates and billing procedures.

...(A) Definitions of terms used for billing and calculating rates. (1) "Base rate," as used in table A, column 3 of paragraph (B) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for the first thirty-five to sixty minutes of service delivered. (2) "Bid rate," as used in table B, column 3 of paragraph (B) of this rule, means the per job bid rate negotiated between the provider and the...

Rule 5160-46-06 | Ohio home care waiver program: covered services, reimbursement rates, and billing procedures.

...(A) The following waiver services are covered by the Ohio home care waiver: (1) Home delivered meals as described in rule 5160-44-11 of the Administrative Code (2) Home maintenance and chores as described in rule 5160-44-12 of the Administrative Code (3) Home modification as described in rule 5160-44-13 of the Administrative Code (4) Community integration as described in rule 5160-44-14 of ...

Rule 5160-46-06.1 | Ohio home care waiver program: home care attendant services reimbursement rates and billing procedures.

...(A) Definitions of terms used for billing and calculating home care attendant services (HCAS) rates. (1) "Base rate," as set forth in column 3 of tables A and B of this rule, means the amount reimbursed by Ohio medicaid for the first thirty-five to sixty minutes of assistance with self-administration of medications and the performance of nursing tasks provided during a single visit. (2) "Continuous nursing" means n...

Rule 5160-46-09 | Ohio home care waiver: vehicle modification service.

...This rule sets forth the definition of the vehicle modification service as well as the provider requirements and specifications for the delivery of the service. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administrative Code. (A) "Vehicle modifications" are adapt...

Rule 5160-46-11 | Ohio home care waiver: supplemental assistive and adaptive device service.

...This rule sets forth the definition of the supplemental assistive and adaptive devices service and provider requirements and specifications for the delivery of the service. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administrative Code. (A) "Supplemental adaptive an...

Rule 5160-46-12 | Ohio home care waiver: adult day health center service.

...This rule sets forth the definition of the adult day health center service as well as the provider requirements and specifications for the delivery of the service. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administrative Code. (A) "Adult day health center serv...

Rule 5160-51-10 | Helping Ohioans move, expanding choice (HOME choice).

...(A) Helping Ohioans move, expanding choice (HOME choice) assists individuals to transition from an institutional setting into a community setting. (B) Definitions (1) "Assessment" means an in-person meeting with the HOME choice applicant to determine eligibility for the program, conducted by the Ohio department of medicaid (ODM) or its designee. (2) "Community setting" means a location that me...

Rule 5160-51-10 | Helping Ohioans move, expanding choice (HOME choice).

...(A) Helping Ohioans move, expanding choice (HOME choice) assists individuals to transition from an institutional setting into a community setting. (B) Definitions (1) "Community setting" means a location that meets the home and community-based setting requirements set forth in rule 5160-44-01 of the Administrative Code or for those moving from an intermediate care facility for individuals with ...

Rule 5160-56-01 | Hospice services: definitions.

...This rule set forth terms used throughout Chapter 5160-56 of the Administrative Code. (A) "Advance directive" refers to written instructions recognized under state law that are related to the provisions of health care when the individual is incapacitated. Samples of advance directive documents include a living will, a declaration as defined in Chapter 2133. of the Revised Code, and a durable power...

Rule 5160-56-02 | Hospice services: eligibility and election requirements.

...This rule sets forth the criteria that must be met for an individual eligible for medicaid to receive the Ohio medicaid hospice benefit. (A) To be covered under Ohio medicaid, the designated hospice must ensure the following criteria are met prior to furnishing hospice care: (1) The designated hospice has a certification of the terminal illness on behalf of the individual, obtained in accordance...