Section 5160-15-21 - Transportation: services from an eligible provider: conditions of provider participation(A) Definition. "Eligible provider" has the same meaning as in rule 5160-1-17 of the Administrative Code.(B) Transportation-specific criteria. For each entity enrolled as an eligible provider of transportation services, the following conditions are met: (1) The entity, each crew member, and each attendant comply with all applicable local, state, and federal laws, regulations, and rules, including all applicable provisions developed in accordance with Chapter 4765. or Chapter 4766. of the Revised Code;(2) Each vehicle meets all applicable permit provisions developed in accordance with Chapter 4766. of the Revised Code; and(3) If the entity provides ground ambulance services, it is also enrolled in medicare as an ambulance service provider or supplier.(C) Rendering provider. The following eligible providers may render a transportation service: (1) A wheelchair van provider;(2) An ambulance provider;(4) A provider under contract with a medicaid managed care organization.(D) Billing ("pay to") provider. The following eligible providers may receive medicaid payment for submitting a claim for a transportation service:(1) A wheelchair van provider;(2) An ambulance provider;(4) A provider under contract with a medicaid managed care organization.(E) Prescribing or referring provider. (1) The following practitioners may certify the necessity of either a wheelchair van service or an ambulance service: (a) An advanced practice registered nurse;(b) A doctor of medicine, osteopathy, or podiatric medicine;(c) A physician assistant; or(d) Any other professional recognized by the department as having prescriptive authority.(2) The following practitioners may certify the necessity of a wheelchair van service:(b) A licensed practical nurse or registered nurse;(c) An occupational therapist or physical therapist;(e) A certified rehabilitation counselor; or(f) Any other professional recognized by the department as having the qualifications necessary to determine whether an individual needs a mobility device. Ohio Admin. Code 5160-15-21
Effective: 7/1/2021
Five Year Review (FYR) Dates: 4/16/2021 and 07/01/2026
Promulgated Under: 119.03
Statutory Authority: 5164.02
Rule Amplifies: 5164.02
Prior Effective Dates: 04/07/1977, 12/21/1977, 12/30/1977, 12/03/1981, 08/15/1982, 05/09/1986, 12/01/1990, 05/01/1992 (Emer.), 08/13/1992, 07/05/1993, 01/01/1994, 04/01/1994, 10/01/1997, 03/01/2000, 12/31/2001, 10/01/2003, 12/30/2005 (Emer.), 03/27/2006, 04/01/2016