Ohio Administrative Code Search

...s standards of accountability for a provider when the individual service plan of an individual served by the provider indicates the provider is responsible for managing the individual's personal funds. (B) Scope This rule applies to persons and entities that provide specialized services regardless of source of payment, including but not limited to: (1) County boards and entities under contr...

...andards for certification of agency providers of supported living services, including home and community-based services provided in accordance with section 5123.045 of the Revised Code. (B) Standards of service provision For the purposes of this rule, the following definitions apply: (1) "Abuser registry" has the same meaning as in rule 5123-17-03 of the Administrative Code. (2) "Accredite...

...ds for certification of independent providers of supported living services, including home and community-based services provided in accordance with section 5123.045 of the Revised Code. (B) Definitions For the purposes of this rule, the following definitions apply: (1) "Abuser registry" has the same meaning as in rule 5123-17-03 of the Administrative Code. (2) "Agency provider" has the...

...artment, obtain and maintain a medicaid provider agreement with the Ohio department of medicaid, and comply with rules in Chapter 5123-9 of the Administrative Code for the specific home and community-based services provided. (4) A licensee shall: (a) Electronically notify the department if the licensee, operator, or administrator has been or is formally charged with, convicted of, pleads gui...

...least five years of experience as a provider licensed to operate a residential facility in Ohio in accordance with section 5123.19 of the Revised Code. (D) Standards for evaluating potential receivers The standards to be considered by the department for evaluating persons to be included on a list of potential receivers include, but are not limited to: (1) Substantial compliance with require...

...) Taking measures to recruit sufficient providers of services to meet the needs of individuals receiving services in the county; and (f) Meeting with each newly certified independent provider within sixty calendar days of the provider being selected to provide services to an individual, for purposes of confirming the provider understands the individual service plan and the provider's responsibili...

...) Taking measures to recruit sufficient providers of services to meet the needs of individuals receiving services in the county; and (f) Meeting with each newly certified independent provider within sixty calendar days of the provider being selected to provide services to an individual, for purposes of confirming the provider understands the individual service plan and the provider's responsibili...

...istrator, direct support professionals, providers, licensed or certified professionals, and any other persons chosen by the individual to help the individual consider possibilities and make decisions. (C) Decision-making responsibility (1) Individuals, including individuals who have been adjudicated incompetent pursuant to Chapter 2111. of the Revised Code, have the right to participate in decis...

...ator, direct support professionals, providers, licensed or certified professionals, and any other persons chosen by the individual to help the individual consider possibilities and make decisions. (C) Decision-making responsibility (1) Each individual, including an individual who has been adjudicated incompetent pursuant to Chapter 2111. of the Revised Code, has the right to participate in d...

...ator, direct support professionals, providers, licensed or certified professionals, and any other persons chosen by the individual to help the individual consider possibilities and make decisions. (C) Decision-making responsibility (1) Each individual, including an individual who has been adjudicated incompetent pursuant to Chapter 2111. of the Revised Code, has the right to participate in d...

...erms of the contract of the service provider, as required by section 5126.45 of the Revised Code, prior to beginning the process for resolution of complaints or appeals of adverse action established in this rule. (C) Definitions For the purposes of this rule, the following definitions shall apply: (1) "Adverse action" means any of the following: (a) Denial of a request for a non-medicaid ...

...ilities personnel holds independent provider certification issued by the department. (B) Training programs for developmental disabilities personnel (1) Health-related activities and prescribed medication administration training program (a) A health-related activities and prescribed medication administration training program provided pursuant to this rule, to prepare developmental disabiliti...

... disabilities personnel and independent providers shall ensure documentation, including the date, time, and signature or initials of certified developmental disabilities personnel who sign the medication/treatment administration record is completed in accordance with this rule. (C) Requirements for developmental disabilities personnel to report medication/treatment errors (1) Any medication/tre...

... for medicare and medicaid services provider reimbursement manual (publications 15-1 and 15-2, available at https://www.cms.gov/regulations-and-guidance/guidance/manuals/paper-based-manuals.html); and (3) Generally accepted accounting principles in accordance with standards prescribed by the "American Institute of Certified Public Accountants" (available at https://www.aicpa.org). (B) "D...

...ility may provide. (c) Hold a medicaid provider agreement with the Ohio department of medicaid to operate the ICFIID. (2) An operator shall: (a) Execute the provider agreement in the format provided by the Ohio department of medicaid. (b) Apply for and maintain a valid license issued by the department. (c) Comply with the provider agreement and all applicable federal, state, and local laws and r...

...nd upon termination of the ICFIID's provider agreement by the Ohio department of medicaid. (B) Payment during the appeals process When the Ohio department of medicaid is required to provide an adjudicatory hearing pursuant to Chapter 119. of the Revised Code, payment shall continue for medicaid-covered services provided to eligible residents during the appeal of and the proposed termination ...

...ive date of termination of the ICFIID's provider agreement. (2) Payment may be provided up to an additional thirty calendar days following either the cessation of payment on the one hundred twentieth calendar day post termination or non-renewal; or after the issuance of an adjudication order that upholds the termination or non-renewal action. Payment will be available if both of the following...

... termination of an ICFIID's medicaid provider agreement except when the ICFIID becomes a downsized ICFIID as defined in section 5124.01 of the Revised Code or converts beds from ICFIID services to home and community-based services in accordance with section 5124.60 or 5124.61 of the Revised Code. No span of bed-hold days shall be approved that ends on an ICFIID's date of closure or termination ...

...dentists are reimbursed directly to the provider of the dental services in accordance with Chapter 5160-5 of the Administrative Code. Personal hygiene services provided by staff or contracted personnel of the ICFIID are reimbursed through the ICFIID cost report mechanism. (C) Laboratory and x-ray services Costs incurred for the purchase and administration of tuberculin tests, and for drawing spe...

...8 of the Administrative Code. The provider is not to change the accumulated depreciation that has been previously reported. This accumulated depreciation will be carried forward as previously reported and audited. The current depreciation will then be added to accumulated depreciation as recognized. (b) Except as otherwise required by paragraph (C)(4)(e) of this rule, depreciation expen...

...8 of the Administrative Code. The provider is not to change the accumulated depreciation that has been previously reported. This accumulated depreciation will be carried forward as previously reported and audited. The current depreciation will then be added to accumulated depreciation as recognized. (b) Except as otherwise required by paragraph (C)(4)(e) of this rule, depreciation expen...

...olation of cost reporting provisions or provider agreement obligations. (d) Interest monies owed to the department pursuant to section 5124.41 of the Revised Code and to the centers for medicare and medicaid services pursuant to 42 C.F.R. 488.442, as in effect on the effective date of this rule. (e) Monies owed to the department and the centers for medicare and medicaid services pursuant to sect...

...Administrative Code. (c) Be a medicaid provider in an active enrollment status for all dates within the claim span. (2) A single claim will include days of service provided, including qualifying leave days, for a single resident within a single calendar month and will not cross calendar months. If an ICFIID determines that a claim that has been paid should have included additional per diem service days, the ICFIID ...

... medicaid services publication 15-1, "Provider Reimbursement Manual" (revised January 2005), available at http://www.cms.hhs.gov/manuals. At no time shall a capital asset be depreciated more than its adjusted basis. (d) An ICFIID shall maintain, and provide to the department upon request, detailed depreciation schedules to verify each individual capital asset placed in service. (E) Salvage value ...

...nd medicaid services publication 15-1, "Provider Reimbursement Manual" (revised January 2005), available at http://www.cms.hhs.gov/manuals, shall be considered sufficient documentation of the allocation of time. If the department finds that the ICFIID has not sufficiently documented the allocation of time, the cost associated with the undocumented time will be reclassified back to the indirect cos...