Ohio Code 5166.16 – Integrated care delivery system medicaid waiver
(A) As used in this section and section 5166.161 of the Revised Code, “ODA or MCD medicaid waiver component” means all of the following:
Terms Used In Ohio Code 5166.16
- Home and community-based services medicaid waiver component: means a medicaid waiver component under which home and community-based services are provided as an alternative to hospital services, nursing facility services, or ICF/IID services. See Ohio Code 5166.01
- Medicaid waiver component: means a component of the medicaid program authorized by a waiver granted by the United States department of health and human services under section 1115 or 1915 of the "Social Security Act" 42 U. See Ohio Code 5166.01
- Ohio home care waiver program: means the home and community-based services medicaid waiver component that is known as Ohio home care and was created pursuant to section 5166. See Ohio Code 5166.01
(1) The medicaid-funded component of the PASSPORT program;
(2) The medicaid-funded component of the assisted living program;
(3) The Ohio home care waiver program.
(B) The medicaid director may create a home and community-based services medicaid waiver component as part of the integrated care delivery system. If the ICDS medicaid waiver component is created, both of the following apply:
(1) The department of medicaid shall administer it;
(2) When it begins to accept enrollments, no ICDS participant who is eligible for the ICDS medicaid waiver component shall be enrolled in an ODA or MCD medicaid waiver component regardless of whether the participant prefers to remain or be enrolled in an ODA or MCD medicaid waiver component.
(C) A dual eligible individual who is eligible for an ODA or MCD medicaid waiver component may enroll in the component before the individual becomes an ICDS participant. The dual eligible individual shall disenroll from the ODA or MCD medicaid waiver component and enroll in the ICDS medicaid waiver component once the individual becomes an ICDS participant and it is possible to enroll the individual in the ICDS medicaid waiver component. The disenrollment from the ODA or MCD medicaid waiver component and enrollment into the ICDS medicaid waiver component shall occur regardless of whether the individual prefers to remain enrolled in the ODA or MCD medicaid waiver component.
(D) An ICDS participant’s disenrollment from an ODA or MCD medicaid waiver component and enrollment in the ICDS medicaid waiver component resulting from division (B)(2) or (C) of this section shall be accomplished without a disruption in the participant’s services under the components.
Last updated October 6, 2023 at 10:37 AM