Ohio Administrative Code Search

...r library supplies; (5) Movie or game purchases and rentals; (6) Chapel expenses; (7) Bus rentals and bus fares; (8) Occupational or activity therapy supplies; and (9) Benefit clients of the community support network. (E) Other disbursements: Disbursements in the amount of one thousand dollars or less may be made with the approval of the chief executive officer or his designee. Expenditures in excess of one t...

...brary supplies; (5) Movie or game purchases and rentals; (6) Chapel expenses; (7) Bus rentals and bus fares; (8) Occupational or activity therapy supplies; and (9) Benefit clients of the community support network. (E) Other disbursements Disbursements in the amount of one thousand dollars or less may be made with the approval of the chief executive officer or the chief executive of...

...holesale transactions or personal items purchased through commissary vendors. (8) Items for sale in or for operation of commissaries may be purchased from the department's Ohio pharmacy services office or from local suppliers. (9) Items purchased locally shall be obtained at the lowest prices available and informal bidding procedures shall be used whenever possible. It is the responsibility of the business office t...

...sale transactions or personal items purchased through commissary vendors. (8) Items for sale in or for operation of commissaries may be purchased from requisite purchase programs specified in Ohio administrative policy PM-01 (including the department's Ohio pharmacy services office) or from local suppliers. Before seeking bids from local suppliers, the business office of the RPH will determin...

...ing reasonable funds for the occasional purchase of gifts for family and friends, or for donations to charities or churches; (m) Advocacy; (n) Services of a representative payee or conservator if not available through other third party sources; (o) Guardianship or other protective service listed in paragraph (C)(9) of this rule; (p) Someone other than mental health community support staff members ...

...ing reasonable funds for the occasional purchase of gifts for family and friends, or for donations to charities or churches; (m) Advocacy; (n) Services of a representative payee or conservator if not available through other third party sources; (o) Guardianship or other protective service listed in paragraph (C)(9) of this rule; (p) Someone other than mental health community support staff members ...

...ncluding any person or entity which purchases the certified program's corporate or managing entity, or enters into any similar purchase agreement. . A provider may not grant the use of its certification to another entity. (M) A provider shall produce the certificate for review upon request of a client or the department. (N) A provider shall immediately notify the department and the applicable al...

...oor and the time of day prohibits their purchase staff must remain awake and on duty twenty-four hours a day until detectors and extinguishers can be purchased and installed. (E) Smoke detectors and fire extinguishers shall be visually inspected and manually tested by the operator as required by the state fire code. (F) Each facility shall have installed appropriate alarms, lights or other safety devices and suppor...

...tion in theft offense, falsification to purchase firearm, or falsification to obtain a concealed handgun license); (xix) 2921.34 (escape); (xx) 2921.35 (aiding escape or resistance to lawful authority); (xxi) 2921.36 (illegal conveyance of weapons, drugs, or other prohibited items onto grounds of detention facility or institution); (xxii) 2925.05 (funding of drug or marihuana t...

...y, including any person or entity which purchases the licensed program or the licensed program's corporate or managing entity, or enters into any similar purchase agreement. (F) The license must be posted in an area visible to residents and visitors at the program facility at all times and made available for inspection to any person who requests it. (G) The department may conduct surveys or ins...

...y, including any person or entity which purchases the licensed program or the licensed program's corporate or managing entity, or enters into any similar purchase agreement. (G) The license must be posted in an area visible to residents and visitors at the program facility at all times and made available for inspection to any person who requests it. (H) The department may conduct surveys or inspect...

...(S) "Project" means the construction or purchase and renovation of facilities, including equipment, for a community mental health or addiction treatment or support service or program as proposed and set forth in an application for state construction assistance. (T) "Project costs" means total costs of capital facilities as defined in division (K) of section 154.01 of the Revised Code, and includes, without limitatio...

...(T) "Project" means the construction or purchase and renovation of facilities, including equipment, for a community mental health or addiction treatment or support service or program as proposed and set forth in an application for state construction assistance. (U) "Project costs" means total costs of capital facilities as defined in division (K) of section 154.01 of the Revised Code, and include...

...e chief, as a part of a construction or purchase and renovation project, may consider and include the value of property owned by an applicant or the approved tax credit owner for which it is the approved tax credit manager as part or all of the applicant's share of approved project costs in an amount that does not exceed the applicant's share of approved project costs. (1) The property and/or buildings thereon must ...

...ief, as a part of a construction or purchase and renovation project, may consider and include the value of property owned by an applicant or the approved tax credit owner for which it is the approved tax credit manager as part or all of the applicant's share of approved project costs in an amount that does not exceed the applicant's share of approved project costs. (1) The property or buildin...

...isting buildings thereon which is to be purchased by an applicant or the approved tax credit owner for which it is the approved tax credit manager. (A) Site evaluation. Applicant shall provide to the chief an evaluation of the proposed project site in accordance with the factors set forth in the guidelines including, but not limited to, cost adaptability for renovation, programmatic suitability, economic suitability...

...ting buildings thereon which is to be purchased by an applicant or the approved tax credit owner for which it is the approved tax credit manager. (A) Site evaluation An applicant will provide to the chief an evaluation of the proposed project site in accordance with the factors set forth in the community capital assistance projects process guidelines (updated April 2019), available at https://mh...

...ger. (2) In projects which involve the purchase and renovation of an existing facility approved by the state, the state participation share of the approved site value may be reimbursed to the applicant on receipt by the chief of appropriate evidence of ownership of the site by the applicant or the approved tax credit owner for which it is the approved tax credit manager. (B) State participation in construction cost...

...ager. (3) In projects that involve the purchase and renovation of an existing facility approved by the state, the state participation share of the approved site value may be reimbursed to the applicant on receipt by the chief of appropriate evidence of ownership of the site by the applicant or the approved tax credit owner for which it is the approved tax credit manager. (B) State participation ...

... and nonprofit corporations for the purchase, construction, and renovation of non-residential capital facilities. (B) Definitions For the purposes of this rule, the following definitions apply: (1) "Applicant" means any of the following who submit an application to the department for community capital assistance funds: (a) A board of county commissioners; (b) A county board of developmental d...

...der to construct a residence or the purchase of a manufactured home from a manufacturer. (4) "County board" means a county board of developmental disabilities. (5) "Department" means the Ohio department of developmental disabilities. (6) "Duplex" means a separate or detached residence with two dwelling units designed and arranged for use by two families separated by a horizontal or vertical...

...builder to construct a residence or the purchase of a manufactured home from a manufacturer. (3) "County board" means a county board of developmental disabilities. (4) "Department" means the Ohio department of developmental disabilities. (5) "Duplex" means a separate or detached residence with two dwelling units designed and arranged for use by two families separated by a horizontal or vertical...

...apital bond funds that are used for the purchase or construction of community-based housing projects. Based on available funding, the department shall distribute community capital assistance funds to applicants using a formula developed by the department. The department may participate at a percentage level of the cost of the residential facility. (4) "Construction" means the construction of ...

...n theft offense, falsification to purchase firearm, or falsification to obtain a concealed handgun license); (xix) 2921.34 (escape); (xx) 2921.35 (aiding escape or resistance to lawful authority); (xxi) 2921.36 (illegal conveyance of weapons, drugs, or other prohibited items onto grounds of detention facility or institution); (xxii) 2925.05 (funding of drug or marihuana traffic...

...to use as the individual chooses to purchase items, goods, and services. (5) In no circumstance will an individual be required to use personal funds to purchase or pay for items or services that are reimbursed by medicaid or any other funding source of the provider. (E) Avoiding conflicts of interest Providers, immediate family members of providers, employees of providers, and immediate fam...

... encourage each individual to select, purchase, and maintain the individual's own clothing and to dress as independently as possible. (3) When an individual has been assessed to need assistance with management of personal possessions, the operator shall record the individual's clothing and personal belongings within fourteen calendar days of admission and update the record at least annually...

...using personal needs allowance funds to purchase life insurance, grave space, a burial account, or other item that may be considered a countable resource, the ICFIID shall refer the resident or the resident's representative, as applicable, to the county department of job and family services for an explanation of the effect the purchase may have on the resident's medicaid eligibility. (F) Limitati...

...using personal needs allowance funds to purchase life insurance, grave space, a burial account, or other item that may be considered a countable resource, the ICFIID shall refer the resident or the resident's representative, as applicable, to the county department of job and family services for an explanation of the effect the purchase may have on the resident's medicaid eligibility. (F) Limitati...

...using personal needs allowance funds to purchase life insurance, grave space, a burial account, or other item that may be considered a countable resource, the ICFIID will refer the resident or the resident's representative, as applicable, to the county department of job and family services for an explanation of the effect the purchase may have on the resident's medicaid eligibility. (F) Limitatio...

...ay services Costs incurred for the purchase and administration of tuberculin tests, and for drawing specimens and forwarding specimens to a laboratory, are reimbursed through the ICFIID cost report mechanism. All laboratory and x-ray procedures covered under the medicaid program are reimbursed directly to the laboratory or x-ray provider in accordance with Chapter 5160-11 of the Administrativ...

...l. (f) Expense accounts identified as "purchased nursing services" are only to be used to report costs incurred for personnel acquired through a nursing pool agency. (g) Expense accounts designated as "other" may be used to report any appropriate non-wage expenses, including contract services and supplies. (h) Completion of the cost report requires that the number of hours paid be reported (dep...

...l. (f) Expense accounts identified as "purchased nursing services" are only to be used to report costs incurred for personnel acquired through a nursing pool agency. (g) Expense accounts designated as "other" may be used to report any appropriate non-wage expenses, including contract services and supplies. (h) Completion of the cost report requires that the number of hours paid be reported (dep...

...l. (f) Expense accounts identified as "purchased nursing services" are only to be used to report costs incurred for personnel acquired through a nursing pool agency. (g) Expense accounts designated as "other" may be used to report any appropriate non-wage expenses, including contract services and supplies. (h) Completion of the cost report requires that the number of hours paid be reported (dep...

...renovation directly attributable to the purchase of property and equipment costs from one related party to another through common ownership or control shall be based upon the lesser of the actual purchase of property and equipment costs or the actual costs of the related party. (D) Criteria for treatment as a nonextensive renovation (1) The following shall apply in order to determine if a projec...

...renovation directly attributable to the purchase of property and equipment costs from one related party to another through common ownership or control will be based upon the lesser of the actual purchase of property and equipment costs or the actual costs of the related party. (D) Criteria for treatment as a nonextensive renovation (1) The following will apply in order to determine if a project ...

... technology equipment is charged to purchase an item of equipment by the seller and that fully and accurately reflects any discount or rebate the provider receives. The provider shall maintain documentation of the actual price in the form of an invoice from the seller that gives details of date, price, quantity, and type of the assistive technology equipment or other documentation approved by the ...

... technology equipment is charged to purchase an item of equipment by the seller and that fully and accurately reflects any discount or rebate the provider receives. The provider shall maintain documentation of the actual price in the form of an invoice from the seller that gives details of date, price, quantity, and type of the assistive technology equipment or other documentation approved by the ...

...echnology - equipment is charged to purchase an item of equipment by the seller and that fully and accurately reflects any discount or rebate the provider receives. The provider will maintain documentation of the actual price in the form of an invoice from the seller that gives details of date, price, quantity, and type of the assistive technology - equipment or other documentation approved by the...

...echnology - equipment is charged to purchase an item of equipment by the seller and that fully and accurately reflects any discount or rebate the provider receives. The provider will maintain documentation of the actual price in the form of an invoice from the seller that gives details of date, price, quantity, and type of the assistive technology - equipment or other documentation approved by the...

...b) Date of service or, in the case of a purchase of bus fares, taxicab tokens, or similar types of travel vouchers to be used on more than one date, date of purchase. (c) Name of individual receiving service. (d) Medicaid identification number of individual receiving service. (e) Name of provider. (f) Provider identifier/contract number. (g) Receipt issued by operator of commercial vehicles indic...

...b) Date of service or, in the case of a purchase of bus fares, taxicab tokens, or similar types of travel vouchers to be used on more than one date, date of purchase. (c) Name of individual receiving service. (d) Medicaid identification number of individual receiving service. (e) Name of provider. (f) Provider identifier/contract number. (g) Receipt issued by operator of commercial vehicles indicatin...

...b) Date of service or, in the case of a purchase of bus fares, taxicab tokens, or similar types of travel vouchers to be used on more than one date, date of purchase. (c) Name of individual receiving service. (d) Medicaid identification number of individual receiving service. (e) Name of provider. (f) Provider identifier/contract number. (g) Receipt issued by operator of commercial vehicles indicating the amount...

...b) Date of service or, in the case of a purchase of bus or light rail fares, taxicab tokens, or similar types of travel vouchers to be used on more than one date, date of purchase. (c) Name of individual receiving service. (d) Medicaid identification number of individual receiving service. (e) Name of provider. (f) Provider identifier/contract number. (g) Receipt issued by operator of commercial tran...

...hed usual and customary fare; or (iii) Purchase by a county board of a prepaid card, pass, token, or voucher used by an individual to access commercial transportation. (17) "On-demand taxicab service" means an entity that: (a) Operates one or more motor vehicles to transport passengers between locations and at times of the day or night determined by the passengers (i.e., not on fixed or pre...

...r. (b) Non-medicaid funds available to purchase the item will be identified for an individual enrolled in the level one waiver.

...irected transportation" means a service purchased through the participant-directed budget, that enables an individual to access activities and opportunities available in the broader community such as competitive integrated workplaces, integrated community participation and contribution (e.g., advocacy activities and events), community resources, and businesses consistent with the individual service plan. Self-directe...

...ted transportation" means a service purchased through the participant-directed budget, that enables an individual to access activities and opportunities available in the broader community such as competitive integrated workplaces, integrated community participation and contribution (e.g., advocacy activities and events), community resources, and businesses consistent with the individual servic...

...) The individual does not have funds to purchase the services, equipment, or supplies, and they are not available through another source. (c) The services, equipment, or supplies are required to ensure the health and welfare of the individual. (d) The services, equipment, or supplies are the least costly alternative that reasonably meets the individual's assessed need as evidenced through the co...

...gh the medicaid state plan that are purchased through the participant-directed budget, address a need clearly identified through assessment of the individual, are specified in the individual service plan, and meet all of the following requirements: (a) The services, equipment, or supplies are required to: (i) Decrease the individual's need for other medicaid home and community-based ...

...hrough the medicaid state plan that are purchased through the participant-directed budget, address a need clearly identified through assessment of the individual, are specified in the individual service plan, and meet all of the following requirements: (a) The services, equipment, or supplies are required to achieve at least one of the following objectives: (i) Decrease the individual's need f...

...hrough the medicaid state plan that are purchased through the participant-directed budget, address a need clearly identified through assessment of the individual, are specified in the individual service plan, and meet all of the following requirements: (a) The services, equipment, or supplies are required to achieve at least one of the following objectives: (i) Decrease the individual's need f...

...and benefits; and (vi) Initial grocery purchase which may include food, cleaning products, and household supplies. (b) Community transition does not include: (i) Ongoing monthly rent or mortgage expenses; (ii) Ongoing grocery expenses; (iii) Ongoing utility or service charges; (iv) Ongoing cable and/or internet expenses; (v) Items intended for entertainment or recreational purposes; or (vi) To...

...ing reasonable funds for the occasional purchase of gifts for family and friends or for donations to charities or churches; (m) Personal advocacy; (n) Services of a representative payee or conservator; (o) Guardianship or other protective services listed in section 5123.55 of the Revised Code; (p) Counseling and guidance; (q) Someone to visit the individual periodically and monitor the services h...

...njoyment. (2) "Gift" means an item purchased for a resident of a developmental center to celebrate a special day or occasion including, but not limited to, the resident's birthday, a holiday observed by the resident, or other occasion that is important to the resident. (3) "Industrial and entertainment fund" means funds collected, maintained, and utilized by a developmental center in accorda...

... enjoyment. (2) "Gift" means an item purchased for a resident of a developmental center to celebrate a special day or occasion including, but not limited to, the resident's birthday, a holiday observed by the resident, or other occasion that is important to the resident. (3) "Industrial and entertainment fund" means funds collected, maintained, and utilized by a developmental center in accorda...

...o careful fire safety evaluation before purchase or use. Neoprene or cotton mattresses treated with boric acid are recommended. Polyurethane is not to be used in any living area.

...reful fire safety evaluation before purchase or use. Neoprene or cotton mattresses treated with boric acid are recommended. Polyurethane is not to be used in any living area.

... that provides for the requisition and purchase of supplies, equipment, inventory and control. (E) The CCF shall provide insurance coverage that includes, at a minimum, property and comprehensive, general liability insurance. (F) When a CCF has a canteen available for use by residents, its fiscal operations are strictly controlled by standard accounting procedures (G) The CCF shall have a writ...

... that provides for the requisition and purchase of supplies, equipment, inventory and control. (E) The CCF will provide insurance coverage that includes, at a minimum, property and comprehensive, general liability insurance. (F) When a CCF has a canteen available for use by residents, its fiscal operations are strictly controlled by standard accounting procedures (G) The CCF will have a writte...

...and practice govern the requisition and purchase of supplies equipment, including at a minimum the purchasing procedures and criteria for the selection of bidders and vendors. (8) Written policy, procedure and practice provide for institutional insurance coverage, including at a minimum the following: worker's compensation, general liability for employees, automobile liability, civil liability, a...

...and practice govern the requisition and purchase of supplies equipment, including at a minimum the purchasing procedures and criteria for the selection of bidders and vendors. (8) Written policy, procedure and practice provide for institutional insurance coverage, including at a minimum the following: worker's compensation, general liability for employees, automobile liability, civil liability, a...

...reful fire safety evaluation before purchase or use. Neoprene or cotton mattresses treated with boric acid are recommended. Foamed plastics or foamed rubber such as polyurethane, polystyrene are not to be used in any living area. (14) The detention center has available to it the services of a qualified fire and safety officer who reviews all policies and procedures related to safety and fire ...

...reful fire safety evaluation before purchase or use. Neoprene or cotton mattresses treated with boric acid are recommended. Foamed plastics or foamed rubber such as polyurethane, polystyrene are not to be used in any living area. (14) The detention center has available to it the services of a qualified fire and safety officer who reviews all policies and procedures related to safety and fire ...

...t be maintained for all equipment items purchased with grant funds. Inventories must include the following information for all equipment: number, purchase price, date of acquisition, vendor, condition and location; (M) County-established guidelines will be used for the salvage of unusable, damaged, and/or unrepairable equipment taken out of the juvenile court or projects funded by the youth services grant. If no cou...

...of a new computer system" means the purchase of a "computer system," as defined in this rule, that is not a computer system currently in place nor one for which the acquisition process has been initiated as of April 7, 2009. (3) "Confidential personal information" (CPI) has the meaning as defined by division (A)(1) of section 1347.15 of the Revised Code. The appendix to this rule identifies, ...

...ls, the provision of services or in the purchase of goods and services. (13) The provider, by any act or omission, has negatively affected the health, safety, or welfare of the medicaid recipient or the fiscal or programmatic integrity of the medicaid program. (14) The office of the attorney general, auditor of state, or any board, bureau, commission, or department has recommended that ODM terminate the provider ag...

...on in a theft offense, falsification to purchase a firearm, or falsification to obtain a concealed handgun license); (xix) 2921.34 (escape); (xx) 2921.35 (aiding escape or resistance to lawful authority); (xxi) 2921.36 (illegal conveyance of weapons, drugs or other prohibited items onto the grounds of a detention facility or institution); (xxii) 2925.05 (funding drug traffi...

...uals, the provision of services, or the purchase of goods and services. (h) The attorney general, auditor of state, or any board, bureau, commission, or department has recommended ODM terminate the provider agreement where the reason for the request bears a reasonable relationship to the administration of the medicaid program or the integrity of state and/or federal funds. (i) In accordance with...

...e with paragraph (C)(2) of this rule, a purchase order will be created by ODM against which invoices or intrastate transfer vouchers are submitted, or, in the event of an emergency at a nursing facility, a state issued payment card will be used. (F) The provisions of this rule are applicable only to the extent that monies are available in the resident protection fund.

...hopping" means the ability to obtain or purchase one's necessary items. Necessary items include, but are not limited to, groceries, clothing, and household items. Shopping does not include handling finances or accessing transportation. (15) "Less than twenty-four hour support" means that an individual needs the presence of another person, or the presence of a remote monitoring device that does no...

...hopping" means the ability to obtain or purchase one's necessary items. Necessary items include, but are not limited to, groceries, clothing, and household items. Shopping does not include handling finances or accessing transportation. (18) "Less than twenty-four hour support" means that an individual requires the presence of another person, or the presence of a remote monitoring device that does not require the ind...

...ligible to retain a PNA account for the purchase of items and services of his or her choice. (2) The PNA account is the exclusive property of the resident, who may use the funds in the account as he or she chooses to meet personal needs. (3) Unless a medicaid resident receives additional irregular contributions from another source, all of his or her personal expenses shall be met through the PNA...

...x-ray services. Costs incurred for the purchase and administration of tuberculin tests, and for drawing specimens and forwarding specimens to a laboratory, are paid through the NF per diem. All costs of laboratory and x-ray procedures covered under the medicaid program are paid directly to the laboratory or x-ray provider in accordance with Chapter 5160-11 of the Administrative Code. (E) Medical...

...d this rule, a "sale" occurs when a purchase agreement or similar document that outlines the terms of the purchase and results in the payment of money for the business or bed license, is signed or, if the signature is not dated, the effective date specified in the purchase agreement or similar document. (B) Any nursing facility that sells any of its business or bed licenses in accordance with...

... laboratory holding a current volume purchase contract: (a) Scratch-resistant coated plastic and polycarbonate lenses monofocal, bifocal, or trifocal; (b) Aphakic monofocal and multifocal lenses; (c) A moderately-priced standard acetate or metal frame; and (d) The following items or services: (i) Frosted lenses; (ii) High-index plastic lenses; (iii) Lenses of ...

...f the Administrative Code. (5) "Volume purchase contract," for purposes of this rule, is the current contract designated "medicaid vision volume purchase program: ophthalmic laboratory services and delivery" that is maintained by the Ohio department of administrative services. The contract can be accessed at https://ohiobuys.ohio.gov/page.aspx/en/ctr/contract_browse_public. (C) Providers. (1) R...

... the actual amount the provider paid to purchase the prescribed drug. ODM acquires AAC data through one or more of the following: national survey of retail pharmacy providers, e.g., national average drug acquisition cost (NADAC) rate process, states' surveys of retail pharmacy providers e.g., Ohio average acquisition cost (OAAC), and published compendia prices, e.g., wholesale acquisition cost (WA...

... the actual amount the provider paid to purchase the prescribed drug. ODM acquires AAC data through one or more of the following: national survey of retail pharmacy providers, e.g., national average drug acquisition cost (NADAC) rate process, states' surveys of retail pharmacy providers, and published compendia prices, e.g., wholesale acquisition cost (WAC). (3) "Administration fee" means the max...

...review." This form along with copies of purchase records for the national drug code (NDC) are submitted to pharmacy pricing and audit consultant (PPAC). This information is found at https://medicaid.ohio.gov/stakehiolders-and-partners/phm. (a) PPAC staff evaluate and recommend whether an OAAC rate adjustment is warranted. (b) All OAAC rate adjustments are sent by PPAC to ODM for final approval...

... department to consider whether the purchase of a new piece of equipment might be more cost-effective than continued repair. (10) "Private residence" is a recipient's place of residence other than a long-term care facility (LTCF). (11) "Provider cost" is the amount paid for an item by a DMEPOS provider to a supplier or manufacturer, exclusive of discounts, rebates, and situation-specific ...

... department to consider whether the purchase of a new piece of DME might be more cost-effective than continued repair. (13) "Prior authorization (PA)" has the same meaning as in rule 5160-1-31 of the Administrative Code. (14) "Private residence" is a medicaid-eligible individual's place of residence other than a long-term care facility (LTCF). (15) "Provider cost" is the amount paid for...

...(c) The provision of or payment for the purchase of a medically necessary bathing seat for a resident of a long-term care facility (LTCF) is the responsibility of the LTCF. Therefore, claims submitted to the department for bathing seats furnished to LTCF residents will be denied. (d) Bathing seats on wheels are not to be used simply as transport chairs from which an individual then transfers to a...

...(c) The provision of or payment for the purchase of a medically necessary bathing seat for a resident of a long-term care facility (LTCF) is the responsibility of the LTCF. Therefore, claims submitted to the department for bathing seats furnished to LTCF residents will be denied. (d) Bathing seats on wheels are not to be used simply as transport chairs from which an individual then transfers to a bat...

... oscillation (HFCWO) device on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) is form ODM 10229, "Certificate of Medical Necessity: High-Frequency Chest Wall Oscillation Devices" (7/2018). (3) An initial trial period of at least two months is required. Payment may be made for rental during this trial period, excluding any portion that coincides with an inpati...

... oscillation (HFCWO) device on a rental/purchase basis. (2) Purchase of a HFCWO device will not be considered without an initial trial period lasting at least two months, excluding any portion that coincides with an inpatient hospital stay. Payment may be made for rental during this trial period. (3) The default certificate of medical necessity (CMN) is form ODM 10229, "Certificate of Medical Ne...

...de for an apnea monitor on a rental/purchase basis. (2) The monitoring unit must meet current United States food and drug administration guidelines. (3) The default certificate of medical necessity (CMN) form is the ODM 02900, "Certificate of Medical Necessity: Apnea Monitors" (rev. 7/2018). (4) Payment for the initial rental of an apnea monitor is limited to four months. For this initial renta...

...ade either for additional rental or for purchase, only if the following conditions are satisfied: (a) The monitoring unit meets current United States food and drug administration guidelines. (b) The provider is capable of performing all of the following services: (i) Arranging to have certified individuals provide infant cardiopulmonary resuscitation (CPR) training to caregivers; (ii) Prov...

...be made for a TENS unit on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) form is the ODM 03402, "Certificate of Medical Necessity: Transcutaneous Electrical Nerve Stimulation (TENS) Units" (rev. 7/2018). The CMN must include one of the following statements of need: (a) For neurogenic pain, the following information: (i) An attestation that the individual ...

...be made for a TENS unit on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) form is the ODM 03402, "Certificate of Medical Necessity: Transcutaneous Electrical Nerve Stimulation (TENS) Units" (rev. 7/2018). The CMN includes one of the following statements of need: (a) For neurogenic pain, the following information: (i) An attestation that the individual is exper...

...me with a wheelchair at the time of purchase: (a) A sling or solid seat with back, a captain's chair, or a stadium-style seat; (b) Standard casters or wheels with tires; (c) Standard armrests; (d) Standard front rigging, such as non-elevating legrests with footrests or a footplate; (e) Wheel locks or brakes; (f) With a power mobility device, motors; (g) With a power mobility device, a non-expandab...

... limb. (B) Payment may be made for the purchase of a pneumatic appliance. Payment may be made on a rental/purchase basis for a pneumatic compressor. (C) The default form is the ODM 02929, "Certificate of Medical Necessity: Pneumatic Compression Devices and Accessories" (rev. 7/2018). The CMN must include the following information: (1) A statement that previous treatment produced no signific...

... months), for rental with subsequent purchase, or for purchase outright, as the prescribing practitioner determines to be appropriate. For a covered pneumatic appliance or accessory, payment is made for purchase.

...made for a hospital bed on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) form is the ODM 02910, "Certificate of Medical Necessity: Hospital Beds and Bed Accessories" (rev. 7/2018). The CMN must include an attestation that at least one of the following criteria is met: (a) The individual's condition (e.g., congestive heart failure, chronic obstructive pulmonary d...

...made for a hospital bed on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) form is the ODM 02910, "Certificate of Medical Necessity: Hospital Beds and Bed Accessories" (rev. 7/2018). The CMN includes an attestation that at least one of the following criteria is met: (a) The individual's condition (e.g., congestive heart failure, chronic obstructive pulmonary disea...

...de for a pulse oximeter on a rental/purchase basis. The default certificate of medical necessity (CMN) form is the ODM 03401, "Certificate of Medical Necessity: Pulse Oximeters" (rev. 7/2018). The CMN must include an attestation by a prescriber that a need exists either for diagnostic monitoring or for continuous monitoring: (a) For diagnostic monitoring undertaken in response to an acute cli...

...de for a pulse oximeter on a rental/purchase basis. The default certificate of medical necessity (CMN) form is the ODM 03401, "Certificate of Medical Necessity: Pulse Oximeters" (rev. 7/2018). The CMN includes an attestation by a prescriber that a need exists either for diagnostic monitoring or for continuous monitoring: (a) For diagnostic monitoring undertaken in response to an acute clinica...

...o the main purpose of the SGD; (c) Purchase, rental, lease, subscription, or maintenance associated with a cellular phone, even if the cellular phone has the capability to perform SGD functions; or (d) Features that may be added on to some models of SGD but have been integrated into the particular SGD under consideration. (C) Claim payment. (1) The payment amount for a portable/tablet computer...

...e. (1) Payment may be made for the purchase of a single-user manual or electric lactation pump as a medical supply item or for the rental of a multiple-user lactation pump for a period of ninety days. (2) The default certificate of medical necessity (CMN) form is the ODM 01901, "Certificate of Medical Necessity: Lactation Pumps" (rev. 7/2018). The CMN must include an attestation to at least ...

...or both of the following purposes: (a) Purchase of a single-user manual or electric lactation pump as a medical supply item and purchase of any necessary replacement supplies; or (b) Rental of a multiple-user lactation pump. (2) For a single-user manual or electric lactation pump, a prescription is sufficient. No separate certificate of medical necessity (CMN) is needed. (3) For a multiple-use...

...2) Separate payment may be made for the purchase of one complete set of accessories (e.g., pads, straps, hook-and-loop closures) if the individual does not already have such accessories as a result of previous use of a CPM device. (B) Requirements, constraints, and limitations. No payment is made for a CPM device in any of the following circumstances: (1) The device is used on a joint other ...