Ohio Administrative Code Search

...nce of illness, injury, impairment, disability, or other condition that limits ambulation. Therefore, a wheelchair needs to provide mobility to an individual for whom ambulation is not possible, takes inordinate physical effort, or causes considerable physical discomfort. (b) A wheelchair also needs to be suited to the purposes and daily routines of the individual using it. (c) A manual wheelcha...

..., developmental delay, or developmental disability causing the incontinence; (c) The type of incontinence; and (d) The type and quantity of incontinence garments or incontinence supplies being prescribed. (2) Payment cannot be made for items related to stress incontinence to which no specific physiological, psychological, or physiopsychological cause can be attributed. (3) A certification ...

...gion, race, color, national origin, disability, age, sex, military status, health status, number of pregnancies, or marital status. (2) A medicaid recipient must be able to obtain pregnancy prevention services voluntarily, free from coercion or pressure and free to choose the type or method of service to be used. (3) A medicaid provider must not make the receipt of pregnancy prevention servi...

...gion, race, color, national origin, disability, age, sex, sexual orientation, gender identity, gender expression, military status, health status, number of pregnancies, or marital status. (2) Medicaid-eligible individuals can obtain medicaid-covered pregnancy prevention services voluntarily, free from coercion or pressure and free to choose the type or method of service to be used. (3) The r...

...ising out of an injury, disease, or disability to the member. (OOO) "Waste" means payment for or the attempt to obtain payment for items or services when there may be no intent to deceive or misrepresent, but poor or inefficient billing or treatment methods result in unnecessary costs.

...ividuals diagnosed with a developmental disability who have a level of care that meets the criteria specified in rule 5123-8-01 of the Administrative Code and receive services through a HCBS waiver administered by the Ohio department of developmental disabilities (DODD). (4) Except for individuals receiving medicaid in the adult extension category under section 1902(a)(10)(A)(i)(VIII) of the Soci...

...ender identity, sexual orientation, disability, national origin, race, color, religion, military status, ancestry, genetic information, health status or need for health services. The MCO may not use a policy or practice that has the effect of discrimination on the basis of the criteria listed in this rule. (c) If a member requests disenrollment because he or she meets the requirements of paragrap...

...formation, sexual orientation, age, disability, national origin, military status, ancestry, health status, or need for health services. (9) An agreement by the provider to not hold liable ODM or members in the event that the MCE cannot or will not pay for services performed by the provider pursuant to the contract with the exception that: (a) Federally qualified health centers (FQHCs) and rural ...

...ace, color, national origin, age or disability in the receipt of health services. (21) Appeal to or file directly with the ODM office of civil rights any complaints of discrimination on the basis of race, color, religion, gender, gender identity, sexual orientation, age, disability, national origin, military status, genetic information, ancestry, health status or need for health services in t...

...ntal security income or social security disability insurance determination or has a score of two or greater on at least one of the items in the "mental health needs" or "risk behaviors" sections or a score of three on at least one of the items in the "life domain function" section of the adult needs and strengths assessment (ANSA) administered by an individual with a bachelor's degree or higher an...

... for individuals with an intellectual disability (ICF-IID) or another licensed/certified facility, any facility covered by section 1616(e) of the Social Security Act (42 U.S.C. 1382e(e) (January 1, 2021) residential care facility, adult foster home or another group living arrangement subject to state licensure or certification. (10) The individual is age sixty or older at the time of enrollment...

...ose of correcting, or alleviating a disability. The physical therapy service will be recommended by a licensed physical therapist acting within the scope of his or her practice under Ohio law who holds a current, valid license to practice physical therapy issued under Chapter 4755. of the Revised Code. (b) Qualified practitioners who can deliver the services: (i) Licensed physical therapist who ...

...been determined to have a developmental disability according to section 5123.01 of the Revised Code. (iv) Providing services to an eligible child who is on a waiver program receiving targeted case management from county boards of development disabilities (CBDD). (v) Conducting quality assurance systems reviews. (vi) Conducting activities related to the development, monitoring or implementat...

...means a person with a developmental disability who is eligible to receive HCBS as an alternative to placement in an intermediate care facility for individuals with intellectual disabilities (ICF/IID) under the applicable HCBS waiver. A guardian or authorized representative may give, refuse to give or withdraw consent for services or may receive notice on behalf of an individual to the extent p...

...means a person with a developmental disability who is eligible to receive HCBS as an alternative to placement in an intermediate care facility for individuals with intellectual disabilities (ICF/IID) under the applicable HCBS waiver. A guardian or authorized representative may give, refuse to give, or withdraw consent for services or may receive notice on behalf of an individual to the extent ...

...means a person with a developmental disability who is eligible to receive HCBS as an alternative to placement in an intermediate care facility for individuals with intellectual disabilities (ICF/IID) under the applicable HCBS waiver. A guardian or authorized representative may give, refuse to give, or withdraw consent for services or may receive notice on behalf of an individual to the extent ...

...om among setting options, including non-disability specific settings and an option for a private unit in a residential setting. (a) The setting options are identified and documented in the person-centered services plan and are based on the individual's needs, preferences, and for residential settings, resources available for room and board. (b) For the purposes of this rule, non-disability speci...

...om among setting options, including non-disability specific settings and an option for a private unit in a residential setting. (a) The setting options are identified and documented in the person-centered services plan and are based on the individual's needs, preferences, and for residential settings, resources available for room and board. (b) For the purposes of this rule, non-disability speci...

...or individuals with an intellectual disability (ICF-IID) that has an active medicaid provider agreement in accordance with sections 5124.06 and 5124.07 of the Revised Code; or (b) A nursing facility (NF) certified in accordance with rule 5160-3-02.3 of the Administrative Code; or (c) Another licensed setting approved by ODM or certified by ODA. (C) All providers of out-of-home respite shall...

...23.13 (having weapons while under a disability); (u) 2923.161 (improperly discharging a firearm at or into a habitation or school); (v) 2923.162 (discharge of firearm on or near prohibited premises); (w) 2923.21 (improperly furnishing firearms to minor); (x) 2923.32 (engaging in a pattern of corrupt activity); (y) 2923.42 (participating in a criminal gang); (z) 2925.02 (corrupting anothe...

...23.13 (having weapons while under a disability); (u) 2923.161 (improperly discharging a firearm at or into a habitation or school); (v) 2923.162 (discharge of firearm on or near prohibited premises); (w) 2923.21 (improperly furnishing firearms to minor); (x) 2923.32 (engaging in a pattern of corrupt activity); (y) 2923.42 (participating in a criminal gang); (z) 2925.02 (corrupting another wi...

...or individuals with an intellectual disability (ICF-IID) or another licensed/certified facility, any facility covered by section 1616(e) of the Social Security Act (42 U.S.C. 1382(e) (January 1, 2021)), residential care facility, adult foster home or another group living arrangement subject to state licensure or certification. (8) Sign an agreement prior to waiver enrollment confirming that t...

...ntal retardation or other developmental disability according to section 5126.01 of the Revised Code. (D) Reimbursable activities. (1) Medicaid services listed in paragraph (D) of this rule are reimbursable only if provided to or on behalf of a medicaid eligible individual as defined in paragraph (C) of this rule and by qualified providers as defined in paragraph (E) of this rule. Payment for targeted case managemen...

... are determined to have a developmental disability according to section 5126.01 of the Revised Code. (D) Reimbursable activities. (1) Medicaid services listed in paragraph (D) of this rule are reimbursable only if provided to or on behalf of a medicaid eligible individual as defined in paragraph (C) of this rule and by qualified providers as defined in paragraph (E) of this rule. Payment for tar...

...igion, gender, sexual orientation, age, disability, national origin, veteran's status, military status, genetic information, ancestry, ethnicity, mental ability, behavior, mental or physical disability, use of services, claims experience, appeals, medical history, evidence of insurability, geographic location within the service area, health status or need for health services. The plan will not use any discriminatory ...