5160-4-05 Teaching physician services.

 

 

 

FEDERAL MEDICAID NOTICE AND PUBLIC HEARING NOTICE OHIO DEPARTMENT OF MEDICAID

 

DATE:  January 4, 2016

TIME:   11:00 a.m.

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 and 42 CFR 447.205, the director of the Ohio Department of Medicaid gives notice of the Department's intent to consider the amendment, rescission, or adoption of the rules identified below and to hold a public hearing on these rules.

 

Rule 5160-4-05, "Teaching physician services," sets forth provisions for coverage of and payment for services performed by residents and teaching physicians.  This rule is being rescinded and replaced with a new rule of the same number titled "Services rendered under the supervision of a teaching practitioner." The new rule is streamlined, clarified, and updated, and unnecessary provisions are removed.  In particular, detailed requirements concerning the supervision of certain services are omitted; instead, in recognition of the fact that supervision is determined by practice standards, a statement is added that teaching practitioner must provide the level of supervision appropriate to a procedure or service.

Rule 5160-4-19, "Allergy services," sets forth coverage and payment provisions for allergy services.  This rule is being rescinded and replaced with a new rule of the same number. The new rule is extensively streamlined; policy provisions address groups of service by type rather than individual procedures by code, and claim-submission instructions are removed. A provision is removed that disallowed payment for both a professional allergy testing service and an evaluation and management service (i.e., an office visit), and a provision is removed that predicated coverage of certain in vitro blood tests on the infeasibility of performing a skin test.

It is estimated that the rescission and adoption of rule 5160-4-05 will have no effect on annual aggregate Medicaid expenditures.  It is estimated that in the rescission and adoption of rule

5160-4-19, the removal of the restriction on coverage of certain in vitro blood tests may increase annual aggregate Medicaid expenditures by as much as $1.67 million.

 

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, Suite 400, 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, Suite 400, 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, Suite 400, Columbus, OH 43215;

By fax to [phone]; or

By e-mail to [e-mail].