Ohio Administrative Code Search

...(A) The director shall reimburse providers for a maximum of one hearing screening per newborn or infant in accordance with this rule at a rate determined by the director if all the following criteria are met: (1) The screening is performed before the newborn or infant is discharged by the provider; (2) The parent, guardian, or custodian certifies with a signed statement that the family (a) Is financially unable to...

...rty-six months old referred to such provider shall report diagnostic hearing evaluation results to the director, in the manner and format prescribed by the director, within seven business days of diagnostic hearing evaluation. Every diagnositc hearing evaluation shall be submitted for the following: (1) Newborns and infants who did not pass the hearing screening; and (2) Newborns, infants and ch...

...nsible for toxicological supervision of providers of poison information for the center is board-certified or board-eligible for ABAT or American board of medical specialties (ABMS) certification. (3) Providers of poison information who: (a) Are registered nurses licensed to practice nursing as a registered nurse under Chapter 4723. of the Revised Code, pharmacists licensed under Chapter 4729. of the Revised Code, p...

...g physician" means a physician who is a provider and who: (1) Submits, on behalf of an applicant, a medical application for eligibility for the program, in accordance with rules 3701-43-11 and 3701-43-15 of the Administrative Code, and other medical information necessary for the director to determine whether the applicant is medically eligible for the program under rule 3701-43-17 of the Administrative Code; (2) De...

...rposes of reviewing the applications of provider applicants and for making determinations as to whether these applicants are eligible providers. (1) For the purposes of this chapter "provider applicant" means a health care professional, hospital, medical equipment supplier or other individual, group or agency that makes application to become a provider, as defined in paragraph (P) of rule 3701-43-01 of the Administr...

...erning applications by physicians to be providers for the program for medically handicapped children. (B) To be approved as a provider, a physician shall: (1) Be licensed to practice allopathic medicine or osteopathic medicine in the state of Ohio or the state in which the physician's practice is located, if the physician will be providing services outside Ohio; (2) Meet the following certification requirements: ...

...thotics, prosthetics, or wheelchairs, a provider shall meet the requirements of rule 3701-43-02 of the Administrative Code and the following. (B) If the provider is: (1) A prosthetist or orthotist, he or she shall: (a) Hold a current, valid license issued in accordance with Chapter 4779. of the Revised Code; and (b) Be capable of maintaining and repairing the wheelchairs on the provider's premises if he or she ...

...) To be eligible for consideration as a provider, the following applicants must be licensed, registered, or certified in accordance with the following: (1) Advanced practice nurses in accordance with Chapter 4723. of the Revised Code; (2) Ambulances in accordance with Chapter 4766. of the Revised Code; (3) Audiologists in accordance with Chapter 4753. of the Revised Code; (4) Dietitians in accordance with Chapter...

...Administrative Code; and (2) Must meet provider requirements of rule 3701-43-02 of the Administrative Code. (B) A local health department providing public health nursing services for individuals on the program: (1) Must meet the requirements of paragraph (A) of this rule; (2) Must employ, or contract with, licensed registered nurses as defined in division (A) of section 4723.01 of the Revised Code for the purpose...

...(A) The director shall pay providers for diagnostic services and for treatment services and goods furnished to recipients in accordance with this rule. (B) The director shall pay only for services or goods that have been authorized to be provided under the applicable provisions of this chapter. (C) A provider shall submit a request for payment on a form prescribed by the director and containing at least the name an...

...A provider of services approved under rules 3701-43-02 to 3701-43-08 and 3701-43-13 of the Administrative Code may have his or her approval terminated if he or she: (A) Voluntarily terminates his or her medicaid provider agreement or the provider's medicaid provider agreement is terminated by the Ohio department of job and family services; (B) Is deceitful or fraudulent in connection with obtaining approval or i...

...cant's managing physician or other BCMH provider on forms prescribed by the director; (2) The services are furnished by providers, as defined in paragraph (P) of rule 3701-43-01 of the Administrative Code, who are approved under applicable provisions of this chapter to provide the specific services requested and the services are furnished within the period of eligibility for diagnostic services; (3) The services ar...

...isciplinary specialty team or physician provider office team approved by the program for the delivery of service coordination services; and (3) Submit a service coordinator provider application as required in rule 3701-43-02 of the Administrative Code, and include a copy of applicant's resume and current position description that describes how the service coordinator will function within the team. (B) To be eligibl...

...or other legal representative, selected providers of major services, the local health department and the managing physician of the approval or proposed denial of eligibility and the effective date of eligibility determination. The director shall issue this notification within thirty days of the date of receipt of the last document necessary to make the eligibility determination or of the failure to submit timely an a...

...ification from a qualified respite care provider); and lump-sum death benefits. (4) "Maximum ability to pay for medical care" means the difference between the amount a family unit spends, including payroll deductions, for health-related insurance coverage and the sum of the following amounts: (a) Ten per cent of the first fifteen thousand dollars by which the family income exceeds the applicable income guideline, a...

...ification from a qualified respite care provider); and lump-sum death benefits. (6) "Family unit" means the group consisting of the following persons: (a) The eligible participant; (b) The eligible participant's spouse, if married; (c) The eligible participant's parents, if participant is considered a dependent by parents for federal income tax purposes; (d) Other persons who, for federal income tax purposes are...

...ification from a qualified respite care provider); and lump-sum death benefits. (4) "Maximum ability to pay for medical care" means the difference between the amount a family unit spends, including payroll deductions, for health-related insurance coverage and the sum of the following amounts: (a) Ten per cent of the first fifteen thousand dollars by which the family income exceeds the applicable income guidelines, ...

...ient's managing physician or other BCMH provider to the director within eleven months of the date of service on forms prescribed by the director. (C) The managing physician and any provider must furnish any information requested by the director, including but not limited to medical or operative reports, hospital discharge summaries, evaluation reports, and other descriptions of services, that is necessary to determi...

...n request from an applicant, recipient, provider or legal representative of applicant, recipient, or provider, the director may waive any of the requirements in this chapter unless the requirement is specified in statute. (B) The director may not grant a waiver request if the approval of the request is contrary to public interest or there are not sufficient funds to support a waiver request. (C) The director's dec...

...1-43-10 of the Administrative Code of a provider, as defined in paragraph (P) of rule 3701-43-01 of the Administrative Code; and (6) A proposed decision to pay an amount less than the charges for authorized goods or services under rule 3701-43-09 of the Administrative Code. (B) An affected party may request reconsideration of a proposal by the director to make one of the decisions listed in paragraph (A) of this ru...

... of medicine; (2) All members shall be providers; and (3) The members shall be representative of the various disciplines, geographic areas of Ohio and types of treatment facilities, such as hospitals, private and public health clinics and private physicians' offices, involved in the treatment of children with medically handicapping conditions. (B) Except as otherwise provided in this paragraph, members of the medi...

...e funds for payment of hearing aids and provider services; and (3) Maintain administrative records for implementation of the program. (E) Funds shall be disbursed in the manner set forth in this chapter until all funds have been expended.

...5-03 of the Administrative Code. (2) A provider form as prescribed by the director that includes the following: (a) Audiology or hearing aid dealer and fitter practice information; (b) Specific hearing aid or aids to be purchased; (c) Audiogram and other diagnostic audiology test results for the child; and (d) The signature of the audiologist or hearing aid dealer and fitter. (e) A written statement signed by a...

... physician, child's primary medical provider, pediatrician, certified nurse midwife, certified nurse practitioner or clinical nurse specialist. If the director is unable to contact the attending physician, child's primary medical provider, pediatrician, certified nurse midwife, certified nurse practitioner or clinical nurse specialist, the director will communicate the results to the newborn scree...

...1-43-03 of the Administrative Code as a provider for the program for medically handicapped children and is board certified in pediatric endocrinology, medical genetics, or immunology/infectious diseases, or to a cystic fibrosis center approved for the program for medically handicapped children. (b) A child with abnormal results on the screen for sickle cell or other hemoglobin disease will be ref...