Ohio Administrative Code Search

...Enrollment on an Ohio department of medicaid (ODM) -administered waiver is voluntary. Individuals enrolled on an ODM-administered waiver in accordance with rule 5160-46-02 of the Administrative Code shall be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based waiver services, and the selection and control over...

...Enrollment on an Ohio department of medicaid (ODM) -administered waiver is voluntary. Individuals enrolled on an ODM-administered waiver in accordance with rule 5160-46-02 of the Administrative Code shall be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based waiver services, and the selection and control over...

...Enrollment on an Ohio department of medicaid (ODM) -administered waiver is voluntary. Individuals enrolled on an ODM-administered waiver in accordance with rule 5160-46-02 of the Administrative Code will be informed of their rights and responsibilities. Individuals also have choice and control over the arrangement and provision of home and community-based waiver services, and the selection and control over ...

...(A) An individual may choose how waiver services are delivered pursuant to the person-centered planning process outlined in rule 5160-44-02 of the Administrative Code. (B) For purposes of this rule and rule 5160-45-03.5 of the Administrative Code: (1) Home and community-based services (HCBS) are services available under the "Ohio Home Care" and "MyCare" waiver programs as described in chapters ...

...(A) Scope. This rule sets forth provisions governing coverage for self-directed goods and services provided as part of an Ohio department of medicaid-(ODM) administered waiver program. (B) "Self-directed goods and services" are services, equipment, or supplies that: (1) Are not available through the medicaid state plan benefit or a home and community-based services (HCBS) waiver program; (2...

...(A) Ohio department of medicaid (ODM) -administered waiver provider applicants must successfully complete the provider enrollment process set forth in this rule and receive approval from ODM before furnishing services to an individual enrolled on an ODM-administered waiver. Services furnished before ODM approves and enrolls the provider applicant are not reimbursable. (B) The provider applicant m...

...(A) Ohio department of medicaid (ODM) -administered waiver provider applicants must successfully complete the provider enrollment process set forth in this rule and receive approval from ODM before furnishing services to an individual enrolled on an ODM-administered waiver. Services furnished before ODM approves and enrolls the provider applicant and before the provider is added to the approved person-centered servic...

...(A) The Ohio department of medicaid (ODM) or its designee shall continuously monitor every ODM-administered waiver provider. Monitoring activities shall include, but not be limited to: (1) A structural review of compliance with all ODM-administered waiver provider requirements in accordance with paragraph (B) of this rule. (2) Investigation of provider occurrences in accordance with paragrap...

...(A) The Ohio department of medicaid (ODM) or its designee shall continuously monitor every ODM-administered waiver provider. Monitoring activities shall include, but not be limited to: (1) A structural review of compliance with all ODM-administered waiver provider requirements in accordance with paragraph (B) of this rule. (2) Investigation of provider occurrences in accordance with paragrap...

...(A) Unless otherwise stated in paragraphs (A)(1) and (A)(2) of this rule, this rule sets forth the process and requirements for the criminal records checks of persons under final consideration for employment with a waiver agency, and existing employees with a waiver agency in a full-time, part-time or temporary position, and who are providing home and community-based services (HCBS) in an Ohio dep...

...(A) This rule sets forth the process and requirements for the criminal records checks of independent providers of home and community-based services (HCBS) in Ohio department of medicaid (ODM) -administered waiver programs. (B) For the purposes of this rule, (1) "Anniversary date" means the later of the effective date of the provider agreement relating to the independent provider or sixty day...

...(A) The Ohio department of medicaid (ODM) is responsible for the ongoing monitoring and oversight of all ODM-administered waiver service providers and all ODM-administered waiver contractors in order to assure providers' and contractors' compliance with ODM-administered waiver program requirements. (B) Monitoring and oversight of ODM-administered waiver service providers. (1) ODM and its designe...

...(A) Except as set forth in paragraph (H) of this rule, a waiver agency may employ an applicant or continue to employ an employee who has been convicted of or pleaded guilty to an offense listed in paragraph (B)(6) of rule 5160-45-07 of the Administrative Code in a position involving providing home and community-based services (HCBS) to an individual enrolled on an Ohio department of medicaid (ODM)...

...(A) Except as set forth in paragraph (H) of this rule, a waiver agency may employ an applicant or continue to employ an employee who has been convicted of or pleaded guilty to an offense listed in paragraph (B)(6) of rule 5160-45-07 of the Administrative Code in a position involving providing home and community-based services (HCBS) to an individual enrolled on an Ohio department of medicaid (ODM)...

...(A) To be eligible for enrollment in the Ohio home care waiver program, an individual must meet all of the following requirements: (1) Be between the ages of birth through age fifty-nine. (2) Be determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-6 of the Administrative Code.; (3) Participate in an initial assessment to determine if the individual has needs ...

...(A) To be eligible for enrollment in the Ohio home care waiver program, an individual must meet all of the following requirements: (1) Be between the ages of birth through age fifty-nine. (2) Be determined eligible for Ohio medicaid in accordance with Chapters 5160:1-1 to 5160:1-6 of the Administrative Code. (3) Participate in an initial assessment to determine if the individual has needs t...

...This rule sets forth definitions of some services covered by the Ohio home care waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administ...

...This rule sets forth definitions of some services covered by the Ohio home care waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administ...

...This rule sets forth definitions of some services covered by the Ohio home care waiver. This rule also sets forth the provider requirements and specifications for the delivery of those Ohio home care waiver services. Providers are also subject to the conditions of participation set forth in rule 5160-44-31 of the Administrative Code. Services are reimbursed in accordance with rule 5160-46-06 of the Administ...

...(A) Definitions of terms used for billing and calculating rates. (1) "Base rate," as used in table A, column 3 of paragraph (B) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for the first thirty-five to sixty minutes of service delivered. (2) "Bid rate," as used in table B, column 3 of paragraph (B) of this rule, means the per job bid rate negotiated between the provider and the...

...(A) Definitions of terms used for billing and calculating rates. (1) "Base rate," as used in table A, column 3 of paragraph (B) of this rule, means the amount reimbursed by the Ohio department of medicaid (ODM) for the first thirty-five to sixty minutes of service delivered. (2) "Bid rate," as used in table B, column 3 of paragraph (B) of this rule, means the per job bid rate negotiated between the provider and the...

...(A) Definitions of terms used for billing and calculating home care attendant services (HCAS) rates. (1) "Base rate," as set forth in column 3 of tables A and B of this rule, means the amount reimbursed by Ohio medicaid for the first thirty-five to sixty minutes of assistance with self-administration of medications and the performance of nursing tasks provided during a single visit. (2) "Continuous nursing" means n...

...(A) Purpose. (1) This rule specifies the conditions for medicaid payment of targeted case management (TCM), which is comprised of those activities described in section 5126.15 of the Revised Code and in rule 5123:2-1-11 of the Administrative Code, but only to the extent that they are listed in paragraph (D) of this rule as reimbursable activities for medicaid eligible individuals with developmental disabilities. (2...

...(A) Purpose. (1) This rule specifies the conditions for medicaid payment of targeted case management (TCM), which is associated with activities described in section 5126.15 of the Revised Code and in rule 5123-4-02 of the Administrative Code, but only to the extent that they are listed in paragraph (D) of this rule as reimbursable activities for medicaid eligible individuals with developmental di...

...(A) Purpose. (1) This rule specifies the conditions for medicaid payment of targeted case management (TCM), which is associated with activities described in section 5126.15 of the Revised Code and in rule 5123-4-02 of the Administrative Code, but only to the extent that they are listed in paragraph (D) of this rule as reimbursable activities for medicaid eligible individuals with intellectual and...