Ohio Administrative Code › Title 5160 - Ohio Department of Medicaid › Chapter 5160-58 - MyCare Ohio › Section 5160-58-03.2 - MyCare Ohio waiver: member choice, control, responsibilities and participant direction

Current through all regulations passed and filed through July 1, 2024
(A)
								A member may
			 choose to receive MyCare Ohio waiver services from any combination of providers
			 on the provider panel of the MyCare Ohio plan selected by the member pursuant
			 to paragraph (B) of rule
			 5160-58-04 of the Administrative
			 Code.
(B)
								A member receiving waiver services from any MyCare Ohio
			 waiver provider will:
(1)
									Participate with the waiver service coordinator in the
			 development of the person-centered services plan as defined in rule
			 5160-44-02 of the Administrative
			 Code.
(2)
									Decide who from their trans-disciplinary care
			 management team will participate in the development of the person-centered
			 services plan.
(3)
									Communicate to the service provider and, as
			 appropriate, the provider's management staff, personal preferences about the
			 way duties, tasks and procedures are to be performed.
(4)
									Work with the
			 waiver service coordinator and the provider to identify and secure additional
			 service provider orientation, training and/or continuing education within the
			 provider's scope of practice to meet the member's specific
			 needs.
(5)
									Not direct the provider to act in a manner that is
			 contrary to any relevant MyCare Ohio waiver requirements, medicaid rules and
			 regulations, or the provider's policies and procedures.
(6)
									Understand the
			 incident management and reporting responsibilities of the member as set forth
			 in rule 5160-44-05 of the Administrative
			 Code.
(7)
									Communicate to the waiver service coordinator and/or
			 MyCare Ohio plan care manager any significant changes, as defined in rule
			 5160-58-01 of the Administrative
			 Code, that may affect service provision or result in a need for more or fewer
			 hours of service.
(8)
									Sign a complete and accurate timesheet or other
			 documentation, as appropriate, to verify services have been furnished. The
			 member will never approve blank timesheets, or timesheets that have been
			 completed before services have been furnished. Verification may be written or
			 electronic at the discretion of the MyCare Ohio plan, unless otherwise required
			 by rule 5160-1-40 of the Administrative
			 Code. If the individual is unable to provide the signature required to verify a
			 service at the time of the service, the individual will submit an electronic
			 signature or standard signature via regular mail, or otherwise provide a
			 signature in no instance any later than at the next face-to-face visit with the
			 provider.
(9)
									Participate in the recruitment, selection and dismissal
			 of providers in collaboration with the trans-disciplinary care management
			 team.
(10)
									In the manner specified by the waiver service
			 coordinator, notify the provider if the member is going to miss a scheduled
			 visit.
(11)
									Notify the waiver service coordinator if the assigned
			 provider misses a scheduled visit.
(12)
									Notify the
			 waiver service coordinator when any change in provider is necessary.
			 Notification will include the desired end date of the current
			 provider.
(13)
									Participate in the monitoring of the performance of the
			 provider.
(14)
									Understand and abide by the rules governing the MyCare
			 Ohio program.