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This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and universities.

Ohio Administrative Code Search

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Rule 5160-9-01 | Eligible providers of pharmacy services and cost of dispensing survey.

...ncy (DEA) registration; and (b) Has a pharmacist as the "responsible person," as defined in rule 4729-5-11 of the Administrative Code; and (c) Complies with eligible provider rules 5160-1-17 to 5160-1-17.11 of the Administrative Code and signs a provider agreement with the Ohio department of medicaid (ODM). (2) A "hospital" provider acting as a pharmacy in accordance with paragraphs (A)(1)(a) to (A)(1)(c) of this...

Rule 5160-9-01 | Pharmacy services: definitions.

... authorized to be administered by a pharmacist or pharmacy intern in accordance with sections 4729.41 and 4729.45 of the Revised Code and the rules promulgated thereunder. (4) "Equivalent drug product" means drug products with the same active ingredient, strength, and dosage form. (5) "Equivalent generic drug products" means equivalent drug products that are identified by the medicaid d...

Rule 5160-9-03 | Pharmacy services: covered drugs and associated limitations.

...aragraph (D)(3)(b) of this rule. (b) A pharmacist may request prior authorization for an alternative dosage form of a drug to be administered through a tube for patients who are tube fed, if no comparable drugs that do not require prior authorization can be administered through a tube. A pharmacist may also request prior authorization of a seventy-two-hour supply of a dangerous drug that is a COD...

Rule 5160-9-03 | Pharmacy services: covered drugs and associated limitations.

...aragraph (D)(3)(b) of this rule. (b) A pharmacist may request prior authorization for an alternative dosage form of a drug to be administered through a tube for recipients who are tube fed, if no comparable drugs that do not require prior authorization can be administered through a tube. A pharmacist may also request prior authorization of a seventy-two-hour supply of a dangerous drug that is a C...

Rule 5160-9-04 | Pharmacy services: drug utilization review.

..., four licensed and actively practicing pharmacists, and one nonvoting ODM staff person. Candidates may be submitted for consideration by the professional health care associations. (c) The chairperson of the DUR board shall be elected by the membership for a one-year term and must be one of the licensed professionals as specified in paragraph (C)(1)(b) of this rule. (2) Terms (a) Two of the original physician appo...

Rule 5160-9-04 | Pharmacy services: drug utilization review.

..., four licensed and actively practicing pharmacists, and one nonvoting ODM staff person. Candidates may be submitted for consideration by the professional health care associations. (c) The chairperson of the DUR board is elected by the membership for a one-year term and must be one of the licensed professionals as specified in paragraph (C)(1)(b) of this rule. (2) Terms (a) Two of the original phys...

Rule 5160-9-05 | Pharmacy services: payment for prescribed drugs.

... authorized to be administered by a pharmacist or pharmacy intern in accordance with section 4729.45 of the Revised Code and the rules promulgated thereunder. (4) "Calculated allowable" means the sum of the ingredient cost plus any applicable administration fee or professional dispensing fee. (5) "Equivalent drug product" means drug products with the same active ingredient, strength, and dos...

Rule 5160-9-06 | Pharmacy services: billing and recordkeeping requirements.

...verification, and identification of the pharmacist or pharmacy staff member requesting verification; (ii) Obtaining a copy of the prescription from the prescriber via facsimile device; (iii) Obtaining an electronic prescription from the prescriber; or (iv) Obtaining a replacement written prescription from the prescriber on a tamper-resistant form. (b) The replacement tamper-resistant prescription shall be filed w...

Rule 5160-9-06 | Pharmacy services: billing requirements, record keeping requirements, and cost of dispensing survey.

...cation, and identification of the pharmacist or pharmacy staff member requesting verification; (ii) Obtaining a copy of the prescription from the prescriber via facsimile device; (iii) Obtaining an electronic prescription from the prescriber; or (iv) Obtaining a replacement written prescription from the prescriber on a tamper-resistant form. (b) The replacement tamper-resistant presc...

Rule 5160-27-01 | Eligible provider for behavioral health services.

...e criminal justice system. (7) A pharmacist operating in accordance with rule 5160-8-52 of the Administrative Code. The pharmacist will be an employee or an independent contractor of an entity described in paragraph (A)(1) or (A)(2) of this rule. (B) All practitioners shall practice within their professional scope of practice. (C) Supervisors shall ensure that individuals whom they superv...

Rule 5160-27-01 | Eligible provider of community behavioral health services.

...erson in treatment and recovery. (7) A pharmacist operating in accordance with rule 5160-8-52 of the Administrative Code. (8) A certified peer supporter operating in accordance with rule 5122-29-15.1 of the Administrative Code. (B) All practitioners will practice within their professional scope of practice. (C) Supervisors will ensure that individuals whom they supervise meet the appropri...

Rule 5160-27-02 | Coverage and limitations of behavioral health services.

... their scope of practice; or (2) A pharmacist, rendering services in accordance with rule 5160-8-52 of the Administrative Code. (G) CMS place of service code set descriptions may be found at www.cms.gov. The department further defines place of service 99 as "community," and this place of service may only be used when a more specific place of service is not available. Place of service 99 shal...

Rule 5160-27-02 | Coverage and limitations of behavioral health services.

... their scope of practice; or (2) A pharmacist, rendering services in accordance with rule 5160-8-52 of the Administrative Code. (G) CMS place of service code set descriptions may be found at www.cms.gov. The department further defines place of service 99 as "community," and this place of service may only be used when a more specific place of service is not available. Place of service 99 shal...

Rule 5160-28-03 | FQHC and RHC services: covered services, limitations, and copayments.

...d practice registered nurse, dietitian, pharmacist, registered nurse working under supervision), along with any services or supplies furnished incident to the professional services on the same date; (c) Professional services and related supplies provided at a later date as necessary follow-up to a medical services visit, even if the same services and supplies were also provided as part of (or inc...