Ohio Administrative Code › Title 5160 - Ohio Department of Medicaid › Chapter 5160-27 - Community Mental Health Agency Services › Section 5160-27-01 - Eligible provider for behavioral health services

Current through all regulations passed and filed through July 1, 2024
(A) An "eligible
			 behavioral health provider" for purposes of this chapter is a provider of a
			 mental health or substance use disorder treatment service covered in agency
			 5160 of the Administrative Code and is one of the following:
(1) An entity operating in accordance with
			 section
			 5119.36
			 of the Revised Code and Chapters 5122-24 to 5122-29 and Chapter 5160-1 of the
			 Administrative Code and providing mental health or substance use disorder
			 treatment services.
(2) An entity
			 furnishing mental health and/or substance use disorder services
			  and operating in
			 accordance with rule
			 5160-1-11
			 of the Administrative Code.
(3)
			 Physician, as described in Chapter 4731. of the Revised Code, or physician
			 assistant, as described in Chapter 4730. of the Revised Code, in accordance
			 with agency 4731 and agency 4730 of the Administrative Code respectively and
			 Chapter 5160-4 of the Administrative Code, or a clinical nurse specialist or
			 certified nurse practitioner, as described in Chapter 4723. of the Revised
			 Code . The practitioner described in this
			 paragraph must be an employee or an independent contractor of an entity
			 operating in accordance with paragraph (A)(1) or (A)(2) of this rule.
(4) Registered nurse or licensed practical
			 nurse as defined in section
			 4723.01 of the
			 Revised Code. The nurse must be an employee or an independent contractor of an
			 entity operating in accordance with paragraph (A)(1) or (A)(2) of this rule. A
			 registered nurse or licensed practical nurse must work under an order
			 authorized by one of the practitioners listed in paragraph (A)(3) of this rule,
			 except when a registered nurse performs a nursing regimen in accordance with
			 section
			 4723.01 of the
			 Revised Code or rule
			 5160-27-11
			 of the Administrative Code.
(5) A
			 practitioner type described in rule
			 5160-8-05
			 of the Administrative Code who is an employee or an independent contractor
			 of, or is a supervised trainee with, an entity
			 operating in accordance with paragraph (A)(1) or (A)(2) of this rule.
(6) An unlicensed practitioner operating in
			 accordance with the following requirements as applicable:
(a) An unlicensed practitioner providing
			 mental health services who holds a valid high school diploma or equivalent and
			 has both work experience and training related to the service(s) being provided,
			 and is an employee or an independent contractor of an entity operating in
			 accordance with paragraph (A)(1) or (A)(2) of this rule. These practitioners
			 must operate under the general supervision of one of the practitioners listed
			 in paragraphs (D)(1) to (D)(16) of this rule, in accordance with paragraph
			 (D)(2)(b) of rule
			 5160-8-05
			 of the Administrative Code.
(b) An
			 unlicensed practitioner providing substance use disorder services must operate
			 under the general supervision, in accordance with paragraph (D)(2)(b) of rule
			 5160-8-05
			 of the Administrative Code, of one of the practitioners listed in paragraphs
			 (D)(1) to (D)(16) of this rule, be an employee or an independent contractor of
			 an entity operating in accordance with paragraph (A)(1) or (A)(2) of this rule,
			 and be one of the following provider types:
(i) A chemical dependency counselor assistant
			 operating in accordance with agency 4758 of the Administrative Code, and rule
			 5160-8-05
			 of the Administrative Code.
(ii) A
			 peer recovery supporter who is :
(a)
			 Certified as a peer recovery supporter by the Ohio department of mental health
			 and addiction services; and
(b)
			 Eighteen years of age or older and has a high school diploma or
			 equivalent.
(iii) A care
			 management specialist who meets the following criteria :
(a) Be eighteen years of age or older and
			 have a high school diploma or equivalent.
(b) Have an understanding of substance use
			 disorder treatment and recovery including how to engage a person in treatment
			 and recovery.
(c) Have an
			 understanding of health care systems, social service systems, and the criminal
			 justice system.
(7) A pharmacist operating in accordance with
			 rule 5160-8-52 of the Administrative Code. The pharmacist will be an employee
			 or an independent contractor of an entity described in paragraph (A)(1) or
			 (A)(2) of this rule.