3701-43-14. Authorization for payment of service coordination services

(A) Service coordination services shall be authorized for eligible applicants pursuant to rule 3701-43-13 of the Administrative Code if all of the following apply:

(1) Application for service coordination has been received in accordance with rule 3701-43-13 of the Administrative Code;

(2) Service coordination services are furnished by providers, who are approved under applicable provisions of this chapter to provide the specific services requested and the services are furnished within the period of eligibility for service coordination;

(3) The service coordination services are deemed necessary by the director for the applicant's medically handicapping condition in accordance with medical policies and the applicable standards of care as defined in paragraph (U) of rule 3701-43-01 of the Administrative Code;

(4) The service coordinator shall furnish to the director a comprehensive service plan in accordance with medical policies verifying progress in the coordination of services for the child.

(B) The department shall notify the service coordinator, the local health department jurisdiction and the applicant, parent, guardian or other legal representative of the child in writing of approval or denial of authorization for provision of services under this rule. The director shall issue this notification within sixty days of the date of receipt of the completed application for service coordination filed pursuant to rule 3701-43-13 of the Administrative Code. A notice of proposed denial of authorization for service coordination shall contain a statement of the reasons for the denial and a description of the reconsideration procedure established by paragraph (B) of rule 3701-43-23 of the Administrative Code.

R.C. 119.032 review dates: 10/28/2013 and 10/28/2018
Promulgated Under: 119.03
Statutory Authority: 3701.021
Rule Amplifies: 3701.021 , 3701.022, 3701.023
Prior Effective Dates: 12/1/2001, 9/1/08

Prior History: (Effective: 09/01/2008
R.C. 119.032 review dates: 05/23/2008 and 09/01/2013
Promulgated Under: 119.03
Statutory Authority: 3701.021
Rule Amplifies: 3701.021, 3701.022, 3701.023
Prior Effective Dates: 12/1/2001 )