Happy 2016 to everyone. As I stated at the end of 2015, I would like to focus many of my weekly Medicaid School Program (MSP) topics on the MSP Rules. When I make reference to the “MSP Rules”, I am referring to “Chapter 5160-35” of the Ohio Administrative Code (OAC). I have attached a copy of the MSP rules, and they also can be found on our website, or in Law Writer under the following link: http://codes.ohio.gov/oac/5160-35
In December of 2014, the Ohio Department of Medicaid completed its “5 Year Rule Review”, and the effective date of the current MSP rules are 04/01/2015. There are a total of five sections to the rules, and depending on print size, the rules are between 19 and 22 pages long. The five sections to the MSP rules are as follows:
- 5160-35-01 Definitions
Defines some of the terms that are used in OAC 5160-35.
- 5160-35-02 Qualifications to be a medicaid school program (MSP) provider
Defines the qualifications and requirements to be a Medicaid School Program provider.
- (There is not a section 5160-35-03)
- 5160-35-04 Reimbursement for services provided by medicaid school program (MSP) providers.
Sets forth the requirements for Interim Claiming and Cost Reporting.
- 5160-35-05 Services authorized for medicaid coverage that can be provided by medicaid school program (MSP) providers.
Sets forth the services authorized for Medicaid reimbursement and sets forth the conditions for providing the services.
- 5160-35-06 Other services, medical supplies and equipment authorized for medicaid coverage that can be provided by medicaid school program (MSP) providers.
Defines additional services authorized for Medicaid coverage and sets forth the conditions for reimbursement.
In the coming weeks, I will be covering various rule requirements in detail, with the goal that each MSP provider school district is aware of all of the program requirements and in compliance with all MSP rules.