Individuals enrolled in the individual options waiver program shall be given a free choice of qualified individual options waiver providers in accordance with rules 5160-41-08 and 5123:2-9-11 of the Administrative Code. A provider is qualified if they meet the standards established in paragraph (J) of this rule. DODD shall create and maintain an online database of those providers who are qualified to provide individual options waiver services. This list will be accessible to county boards and individuals applying for or receiving services. The county board shall assist an individual, as needed, with exercising the right to free choice of provider in accordance with rule 5123:2-9-11 of the Administrative Code.
Provider payment standards for the individual options waiver are established in Chapters 5160-41, 5123:2-9, and 5123-9 of the Administrative Code.
ODM shall conduct periodic monitoring and compliance reviews related to the individual options waiver program in accordance with section 5162.10 of the Revised Code. Reviews may consist of, but are not limited to, physical inspections of records and sites where services are provided, interviews of providers, recipients, and administrators of waiver services. Certified or licensed individual options waiver providers, in accordance with the medicaid provider agreement, DODD, and county board shall furnish to ODM, the center for medicare and medicaid services (CMS), and the medicaid fraud control unit or their designees any records related to the administration and/or provision of individual options waiver services. Individuals enrolled in the individual options waiver program shall cooperate with all monitoring, compliance, and quality assurance reviews conducted by ODM, CMS, and the medicaid fraud control unit or their designee.
Ohio Admin. Code 5160-40-01
Five Year Review (FYR) Dates: 7/28/2020 and 10/01/2025
Promulgated Under: 119.03
Statutory Authority: 5166.02
Rule Amplifies: 5164.25, 5166.04, 5166.20, 5162.35
Prior Effective Dates: 07/01/2005, 01/01/2007, 07/01/2007, 10/01/2007, 12/21/2007 (Emer.), 03/20/2008, 07/15/2011, 05/01/2017, 02/01/2018, 01/01/2019, 01/01/2020