Ohio Revised Code Chapter 5166 - Federal Medicaid Waiver Programs

• Section 5166.01 - Definitions.
  As used in this chapter: "209(b) option" means the option described in section 1902(f) of the "Social Security Act," 42 U.S.C. 1396a(f), under which...
• Section 5166.02 - [Renumbered From 5111.85] Rules Governing Medicaid Waiver Components.
  (A) The medicaid director shall adopt rules in accordance with Chapter 119. of the Revised Code governing medicaid waiver components . The rules may...
• Section 5166.03 - [Renumbered From 5111.84] Notice Of Intent To Request Medicaid Waiver.
  The medicaid director may not submit a request to the United States secretary of health and human services for a medicaid waiver under the...
• Section 5166.04 - [Renumbered From 5111.851] Home And Community-based Services Medicaid Waiver Components.
  The following requirements apply to each home and community-based services medicaid waiver component: (A) Only an individual who qualifies for a component shall receive...
• Section 5166.05 - [Renumbered From 5111.852] Review Of Plans Of Care And Individual Service Plans.
  The department of medicaid may review and approve, modify, or deny written plans of care and individual service plans that section 5166.04 of the...
• Section 5166.06 - [Renumbered From 5111.853] Agency Records Of Costs Of Medicaid Waiver Components.
  Each administrative agency shall maintain, for a period of time the department of medicaid shall specify, financial records documenting the costs of medicaid services...
• Section 5166.07 - [Renumbered From 5111.854] Agency Accountable For Medicaid Waiver Components Funds.
  Each administrative agency is financially accountable for funds expended for medicaid services covered by the home and community-based services medicaid waiver components that the...
• Section 5166.08 - [Renumbered From 5111.855] Agency Contracting For Medicaid Waiver Components; Assurance Of Compliance.
  Each state agency and political subdivision that enters into a contract with the department of medicaid under section 5162.35 of the Revised Code to...
• Section 5166.10 - [Renumbered From 5111.856] Transfer Of Enrollee In One Medicaid Waiver Component To Another.
  To the extent necessary for the efficient and economical administration of medicaid waiver components, the department of medicaid may transfer an individual enrolled in...
• Section 5166.11 - [Renumbered From 5111.86] Creation Of Medicaid Waiver Components For Home And Community-based Services Programs.
  (A) As used in this section , "Ohio home care program" means the program the department of medicaid administers that provides state plan services...
• Section 5166.12 - [Renumbered From 5111.861] Determination Regarding Continuation Of The Ohio Home Care Waiver Program .
  If the unified long-term services and support medicaid waiver component is created, the departments of aging and medicaid shall collaborate to determine whether the...
• Section 5166.121 - [Renumbered From 5111.862] Home First Component For The Ohio Home Care Waiver Program.
  (A) Unless the Ohio home care waiver program is terminated pursuant to section 5165.12 of the Revised Code, the department of medicaid shall establish...
• Section 5166.13 - [Renumbered From 5111.863] Determination Regarding Continuation Of Ohio Transitions II Aging Carve-out Program.
  If the unified long-term services and support medicaid waiver component is created, the departments of aging and medicaid shall collaborate to determine whether the...
• Section 5166.14 - [Renumbered From 5111.864] Unified Long-term Services And Support Medicaid Waiver Component.
  The department of medicaid shall create a unified long-term services and support medicaid waiver component to provide home and community-based services to eligible individuals...
• Section 5166.141 - [Renumbered From 5111.865] Home First Component For Unified Long-term Services And Support Medicaid Waiver Program.
  The department of medicaid shall establish a home first component for the unified long-term services and support medicaid waiver program. The home first component...
• Section 5166.16 - Integrated Care Delivery System Medicaid Waiver.
  (A) As used in this section and section 5166.161 of the Revised Code, "ODA or MCD medicaid waiver component" means all of the following:...
• Section 5166.161 - Home And Community-based Services For Holocaust Survivors.
  The department of medicaid shall ensure that each ICDS participant who is a survivor of the Holocaust that occurred in Europe during World War...
• Section 5166.20 - [Renumbered From 5111.87] Additional Medicaid Waiver Components For Home And Community-based Services.
  (A) The department of medicaid may create the following: (1) One or more medicaid waiver components under which home and community-based services are provided...
• Section 5166.21 - [Renumbered From 5111.871] Transitions Developmental Disabilities Waiver.
  The department of medicaid shall enter into a contract with the department of developmental disabilities under section 5162.35 of the Revised Code with regard...
• Section 5166.22 - [Renumbered From 5111.872] Allocating Enrollment Numbers To County Board Of Developmental Disabilities.
  (A) Subject to division (B) of this section, when the department of developmental disabilities allocates enrollment numbers to a county board of developmental disabilities...
• Section 5166.23 - [Renumbered From 5111.873] Rules Regarding Payments For Home And Community-based Services Provided Under Medicaid Component.
  (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...
• Section 5166.30 - [Renumbered From 5111.88] Coverage Of Home Care Attendant Services.
  (A) As used in sections 5166.30 to 5166.3010 of the Revised Code: (1) "Adult" means an individual at least eighteen years of age. (2)...
• Section 5166.301 - [Renumbered From 5111.881] Home Care Attendant Services Providers.
  The medicaid director shall enter into a provider agreement with an individual to authorize the individual to provide home care attendant services to consumers...
• Section 5166.302 - [Renumbered From 5111.882] Continuing Education Requirements For Home Care Attendants.
  A home care attendant shall complete not less than twelve hours of in-service continuing education regarding home care attendant services each year and provide...
• Section 5166.303 - [Renumbered From 5111.883] Responsibilities Of Home Care Attendants.
  A home care attendant shall do all of the following: (A) Maintain a clinical record for each consumer to whom the attendant provides home...
• Section 5166.304 - [Renumbered From 5111.884] Nursing Assistance By Home Care Attendants.
  (A) A home care attendant may assist a consumer with nursing tasks or self-administration of medication only after the attendant does both of the...
• Section 5166.305 - [Renumbered From 5111.885] Nursing Assistance By Home Care Attendants; Consent And Authorization.
  A home care attendant shall comply with both of the following when assisting a consumer with nursing tasks or self-administration of medication: (A) The...
• Section 5166.306 - [Renumbered From 5111.886] Nursing Assistance By Home Care Attendants; Writtent Statement Providing Consent.
  To consent to a home care attendant assisting a consumer with nursing tasks or self-administration of medication, the consumer or consumer's authorized representative shall...
• Section 5166.307 - [Renumbered From 5111.887] Nursing Assistance By Home Care Attendants; Written Statement Of Authorization.
  To authorize a home care attendant to assist a consumer with nursing tasks or self-administration of medication, a health care professional shall provide the...
• Section 5166.308 - [Renumbered From 5111.888] Nursing Assistance By Home Care Attendants; Unauthorized Actions.
  When authorizing a home care attendant to assist a consumer with nursing tasks or self-administration of medication, a health care professional may not authorize...
• Section 5166.309 - [Renumbered From 5111.889] Practice Of Nursing As Registered Nurse Or Licensed Practical Nurse Not Allowed By Home Care Attendants.
  A home care attendant who provides home care attendant services to a consumer in accordance with the authorizing health care professional's authorization does not...
• Section 5166.3010 - [Renumbered From 5111.8810] Authorized Representative.
  A consumer who is an adult may select an individual to act on the consumer's behalf for purposes regarding home care attendant services by...
• Section 5166.32 - Medicaid Waiver For Individuals With Cystic Fibrosis.
  If the department of medicaid terminates the 209(b) option, the department shall establish a medicaid waiver component under which an individual who has cystic...
• Section 5166.35 - [Renumbered From 5111.97] Ohio Access Success Project.
  (A) The medicaid director may establish the Ohio access success project to help medicaid recipients make the transition from residing in nursing facilities to...
• Section 5166.40 - Definitions.
  (A) As used in sections 5166.40 to 5166.409 of the Revised Code: (1) "Adult" means an individual who is at least eighteen years of...
• Section 5166.401 - Enrolllment For Healthy Ohio Program Participants.
  A healthy Ohio program participant shall enroll in a comprehensive health plan offered by a managed care organization under contract with the department of...
• Section 5166.402 - Buckeye Accounts For Participants.
  (A) (1) A buckeye account shall be established for each healthy Ohio program participant. Subject to division (A)(2) of this section, a participant's buckeye...
• Section 5166.403 - Debit Swipe Cards.
  (A) A managed care organization that offers the health plan in which a healthy Ohio program participant enrolls shall issue a debit swipe card...
• Section 5166.404 - Points Award System.
  (A) The medicaid director shall establish a system under which points are awarded in accordance with this section to healthy Ohio program debit swipe...
• Section 5166.405 - Cessation Of Participation.
  (A) A healthy Ohio program participant's participation in the program shall cease if any of the following applies: (1) Unless the participant is pregnant,...
• Section 5166.406 - Exhaustion Of Payout Limits.
  If a healthy Ohio program participant exhausts the annual or lifetime payout limits specified in division (D) of section 5166.401 of the Revised Code,...
• Section 5166.407 - Disqualification For Medicaid; Disposition Of Remainder In Buckeye Account.
  (A) If a healthy Ohio program participant ceases to qualify for medicaid due to increased family countable income and purchases a health insurance policy...
• Section 5166.408 - Referral To Workforce Development Agency.
  Each county department of job and family services shall offer to refer to a workforce development agency each healthy Ohio program participant who resides...
• Section 5166.409 - Rules.
  The medicaid director shall adopt rules under section 5166.02 of the Revised Code to do all of the following: (A) For the purpose of...

Last modified: October 10, 2016