5160-4-17 Gastroenterology, otorhinolaryngology, endocrinology, neurology, photodynamic therapy and special dermatology services.

 

 

 

PUBLIC HEARING NOTICE OHIO DEPARTMENT OF MEDICAID

 

DATE:  October 20, 2016

TIME:   11:00 AM

LOCATION:   Room A501, Lazarus Government Center

50 West Town Street, Columbus, OH 43215

 

 

Pursuant to section 5164.02 and Chapter 119. of the Ohio Revised Code, the director of the Ohio Department of Medicaid gives notice of the Department's intent to consider the rescission and adoption of the rules identified below and to hold a public hearing on these rules.

 

The following rules are being proposed for rescission:

 

•         Rule 5160-4-11 titled "Diagnostic and therapeutic procedures,"

•         Rule 5160-4-16 titled "Cardiovascular diagnostic and therapeutic services,"

•         Rule 5160-4-17 titled "Gastroenterology, otorhinolaryngology, endocrinology, neurology, photodynamic therapy and special dermatology services," and

•         Rule5160-4-18 titled "Pulmonary services."

 

These rules are being rescinded because the same coverage and place of service limitations are also found in in Appendix DD to Administrative Rule 5160-1-60, "Medicaid payment." Appendix DD to Rule 5160-1-60, "Medicaid payment" includes coverage and place of services restrictions for professional diagnostic and therapeutic services covered by Medicaid. The rescission of the discipline-specific diagnostic and therapeutic OAC Rules consolidates all diagnostic and therapeutic services coverage and limitations into a single rule.

 

Additionally, since the Ohio Department of Medicaid (ODM) is applying the National Correct Coding Initiative (NCCI) edits to all services, there is no longer a need for OAC rules to outline each discipline of diagnostic and therapeutic services' limits on services performed in conjunction with other services.

 

New rule 5160-4-11, "Place of service restrictions for diagnostic and therapeutic procedures" is being proposed for adoption. This new rule is a placeholder rule that refers the reader to rule 5160-1-60, "Medicaid payment."  It ensures that existing references to rule 5160-4-11 remain functional until they can be updated.

 

The public hearing will be held at the date, time, and location listed at the top of this notice. Both written and oral testimony will be accepted at the public hearing, and written comments submitted or postmarked no later than the date of the public hearing will be treated as testimony.

 

 

 

 

 

 

 

 

 

 

 

 

Any person affected by these rules may examine them and obtain a copy, without charge, at the following locations:

Ohio Department of Medicaid, 50 West Town Street, Fourth Floor, Columbus, Ohio 43215; Any county department of job and family services; or

On the internet at http://www.registerofohio.state.oh.us/.

Testimony on the proposed rules may also be reviewed at the Ohio Department of Medicaid, 50 West Town Street, Fourth Floor, Columbus, Ohio 43215.

Requests for a copy of the proposed rules or a copy of testimony on the rules should be submitted in any of the following ways:

By mail to the Rule Administrator, Office of Chief Legal Counsel, Ohio Department of Medicaid, 50 West Town Street, Fourth Floor, Columbus, OH 43215;

By fax to [phone]; or

By e-mail to [e-mail].