5160-15-21. Transportation: services from an eligible provider: provider requirements

(A) The following eligible providers may render a transportation service:

(1) A wheelchair van provider;

(2) An ambulance provider;

(3) A hospital; or

(4) A provider under contract with a medicaid managed care plan.

(B) 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;

(3) A hospital; or

(4) A provider under contract with a medicaid managed care plan.

(C) The necessity of a transportation service rendered on a fee-for-service basis must be certified by a practitioner holding a current, valid license or certificate to practice in a professional capacity.

(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:

(a) A chiropractor;

(b) A licensed practical nurse or registered nurse;

(c) An occupational therapist or physical therapist;

(d) A psychologist;

(e) A certified rehabilitation counselor; or

(f) Any other professional recognized by the department as having the qualifications necessary to determine whether an individual requires the use of a mobility device.

(D) Each transportation provider, crew member, and attendant must comply with all applicable local, state, and federal laws, regulations, and rules, including all applicable certification or licensure requirements developed in accordance with Chapter 4765. or Chapter 4766. of the Revised Code.

(E) Each vehicle operated by a transportation provider must meet all applicable permit requirements developed in accordance with Chapter 4766. of the Revised Code.

(F) Each out-of-state provider must be approved in accordance with Chapter 5160-1 of the Administrative Code.

(G) Each provider of ground ambulance services must be enrolled in medicare as an ambulance service provider or supplier.

Replaces: Part of 5160-15-02

Effective: 4/1/2016
Five Year Review (FYR) Dates: 04/01/2021
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