5160-12-05 Reimbursement: home health services.  

  • Text Box: ACTION: Original Text Box: DATE: 07/15/2016 9:24 AM

     

     

    FEDERAL MEDICAID AND PUBLIC HEARING NOTICE OHIO DEPARTMENT OF MEDICAID

     

    DATE:                       August 18, 2016

    TIME:                        11:00 A.M.

    LOCATION:               Room A501, Lazarus Building

    50 W. Town St., Columbus, Ohio 43215-3414

     

    Pursuant to 42 C.F.R. 447.205, 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 amendment of OAC 5160-12-05, OAC 5160-12-05 Appendix A and OAC 5160-12-05 Appendix B, as identified below and of a public hearing thereon. It is estimated that changes to this rule will have no impact on the annual aggregate Medicaid expenditures at federal or state level.

     

    OAC 5160-12-05, entitled "Reimbursement: home health services" is being proposed for amendment to comply with recent federal regulations that require new codes to be used for the provision of home health nursing:

     

    ·         Paragraph C was amended to specify the amount of reimbursement for each of the home health service visits (i.e., a home health aide, home health nursing, and skilled therapy visit).

     

    ·         Paragraph F changed to reflect that a visit conducted by a registered nurse (RN) and/or a licensed practical nurse (LPN) for the provision of home health nursing services must be billed to Ohio Medicaid using the Appendices 1 and 2 to the rule.

     

    ·         Appendices A and B were amended to reflect the new billing codes (G-0299 for home health nursing services provided by an RN and G0300 for home health nursing services provided by an LPN) and to remove modifiers currently used to distinguish between nursing visits completed by an RN and LPN (i.e., TD and TE).

     

    ·         Appendix B was also amended to denote that only an RN under billing code G0299 may use the U1 modifier for the purpose of identifying home infusion therapy services provided during a home health nursing visit.

     

    A copy of the proposed rule is available, without charge, to any person affected by the rule at the address listed below and at the county departments of job and family services. The rule is also available on the internet at http://www.registerofohio.state.oh.us/. A public hearing on the proposed rule will be held at the date, time, and location listed at the top of this notice. Both written and oral testimony will be taken at the public hearing. Additionally, written comments submitted or postmarked no later than the date of the public hearing will be treated as testimony.

     

    Requests for a copy of the proposed rule and testimony on the rule should be submitted by mail to the Ohio Department of Medicaid Rule Administrator, Office of Chief Legal Counsel, 50 W. Town St., Suite 400, Columbus, Ohio 43215-3414, by fax at (614) 752-3986, or by e-mail at  Rules@Medicaid.Ohio.gov. Testimony received may be reviewed at this address.