Individuals enrolled in the self-empowered life funding waiver program shall be given a free choice of qualified self-empowered life funding 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)(2) of this rule. DODD shall create and maintain an internet-based list of those providers who are qualified to provide self- empowered life funding 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 self-empowered life funding 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 self-empowered life funding 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 self-empowered life funding 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 self- empowered life funding waiver services. Individuals enrolled in the self-empowered life funding 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 5160-41-17
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: 07/01/2012, 05/01/2017, 02/01/2018, 01/01/2019, 01/01/2020