Ohio Revised Code
Chapter 5166 | Federal Medicaid Waiver Programs
Section 5166.23 | Rules Regarding Payments for Home and Community-Based Services Provided Under Medicaid Component.

Effective: September 29, 2013
Latest Legislation: House Bill 59 - 130th General Assembly
(A) Subject to division (D) of this section, the medicaid director shall adopt rules under section 5166.02 of the Revised Code establishing the payment amounts or the methods by which the payment amounts are to be determined for home and community-based services specified in division (A)(1) of section 5166.20 of the Revised Code and provided under the components of the medicaid program that the department of developmental disabilities administers under section 5166.21 of the Revised Code. With respect to these rules, all of the following apply:
(1) The rules shall establish procedures for the department of developmental disabilities to follow in arranging for the initial and ongoing collection of cost information from a comprehensive, statistically valid sample of persons and government entities providing the services at the time the information is obtained.
(2) The rules shall establish procedures for the collection of consumer-specific information through an assessment instrument the department of developmental disabilities shall provide to the department of medicaid.
(3) With the information collected pursuant to divisions (A)(1) and (2) of this section, an analysis of that information, and other information the director determines relevant, the rules shall establish payment standards that do all of the following:
(a) Assure that payment amounts are consistent with efficiency, economy, and quality of care;
(b) Consider the intensity of consumer resource need;
(c) Recognize variations in different geographic areas regarding the resources necessary to assure the health and welfare of consumers;
(d) Recognize variations in environmental supports available to consumers.
(B) As part of the process of adopting rules authorized by this section, the director shall consult with the director of developmental disabilities, representatives of county boards of developmental disabilities, persons who provide the home and community-based services, and other persons and government entities the director identifies.
(C) The medicaid director and director of developmental disabilities shall review the rules authorized by this section at times they determine are necessary to ensure that the payment amounts or the methods by which the payment amounts are to be determined continue to meet the payment standards established under division (A)(3) of this section.
(D) This section applies to home and community-based services provided under the medicaid waiver component known as the transitions developmental disabilities waiver only to the extent, if any, provided by the contract required by section 5166.21 of the Revised Code regarding the component.

Structure Ohio Revised Code

Ohio Revised Code

Title 51 | Public Welfare

Chapter 5166 | Federal Medicaid Waiver Programs

Section 5166.01 | Definitions.

Section 5166.02 | Rules Governing Medicaid Waiver Components.

Section 5166.03 | Notice of Intent to Request Medicaid Waiver.

Section 5166.04 | Home and Community-Based Services Medicaid Waiver Components.

Section 5166.041 | Provision of Nursing Services in a Group Visit Under a Home and Community-Based Services Medicaid Waiver Component.

Section 5166.05 | Review of Plans of Care and Individual Service Plans.

Section 5166.06 | Agency Records of Costs of Medicaid Waiver Components.

Section 5166.07 | Agency Accountable for Medicaid Waiver Components Funds.

Section 5166.08 | Agency Contracting for Medicaid Waiver Components; Assurance of Compliance.

Section 5166.09 | Reservation of Participant Capacity for Individuals Related to Active Duty Military Who Were Receiving Services in Another State.

Section 5166.10 | Transfer of Enrollee in One Medicaid Waiver Component to Another.

Section 5166.11 | Creation of Medicaid Waiver Components for Home and Community-Based Services Programs.

Section 5166.12 | Determination Regarding Continuation of the Ohio Home Care Waiver Program.

Section 5166.121 | Home First Component for the Ohio Home Care Waiver Program.

Section 5166.14 | Unified Long-Term Services and Support Medicaid Waiver Component.

Section 5166.141 | Home First Component for Unified Long-Term Services and Support Medicaid Waiver Program.

Section 5166.16 | Integrated Care Delivery System Medicaid Waiver.

Section 5166.161 | Home and Community-Based Services for Holocaust Survivors.

Section 5166.20 | Additional Medicaid Waiver Components for Home and Community-Based Services.

Section 5166.21 | Transitions Developmental Disabilities Waiver.

Section 5166.22 | Allocating Enrollment Numbers to County Board of Developmental Disabilities.

Section 5166.23 | Rules Regarding Payments for Home and Community-Based Services Provided Under Medicaid Component.

Section 5166.30 | Coverage of Home Care Attendant Services.

Section 5166.301 | Home Care Attendant Services Providers.

Section 5166.302 | Continuing Education Requirements for Home Care Attendants.

Section 5166.303 | Responsibilities of Home Care Attendants.

Section 5166.304 | Nursing Assistance by Home Care Attendants.

Section 5166.305 | Nursing Assistance by Home Care Attendants; Consent and Authorization.

Section 5166.306 | Nursing Assistance by Home Care Attendants; Written Statement Providing Consent.

Section 5166.307 | Nursing Assistance by Home Care Attendants; Written Statement of Authorization.

Section 5166.308 | Nursing Assistance by Home Care Attendants; Unauthorized Actions.

Section 5166.309 | Practice of Nursing as Registered Nurse or Licensed Practical Nurse Not Allowed by Home Care Attendants.

Section 5166.3010 | Authorized Representative.

Section 5166.32 | Medicaid Waiver for Individuals With Cystic Fibrosis.

Section 5166.37 | Medicaid Waiver - Additional Eligibility Requirements for Members of Expansion Group.

Section 5166.40 | Definitions.

Section 5166.401 | Enrolllment for Healthy Ohio Program Participants.

Section 5166.402 | Buckeye Accounts for Participants.

Section 5166.403 | Debit Swipe Cards.

Section 5166.404 | Points Award System.

Section 5166.405 | Cessation of Participation.

Section 5166.406 | Exhaustion of Payout Limits.

Section 5166.407 | Disqualification for Medicaid; Disposition of Remainder in Buckeye Account.

Section 5166.408 | Referral to Workforce Development Agency.

Section 5166.409 | Rules.