Rule 5160-45-06 | ODM-administered waiver program: structural reviews of providers and investigation of provider occurrences

What this rule requires your agency to do

• 1During a structural review the provider must ensure the availability of required documents and maintain the confidentiality of information about enrolled individuals.(Rule 5160-45-06 | ODM-administered waiver program: structural reviews of providers and investigation of provider occurrences)
• 2The provider must submit a plan of correction for all identified findings within forty-five calendar days after the date on the written report.(Rule 5160-45-06 | ODM-administered waiver program: structural reviews of providers and investigation of provider occurrences)
• 3Non-agency waiver providers are subject to structural reviews during each of the first three years after beginning billable services, and annually thereafter unless the biennial-review criteria are met.(Rule 5160-45-06 | ODM-administered waiver program: structural reviews of providers and investigation of provider occurrences)
• 4When findings of noncompliance are indicated, the provider must respond in writing with a plan of correction, including any individual remediation.(Rule 5160-45-06 | ODM-administered waiver program: structural reviews of providers and investigation of provider occurrences)
• 5Medicare-certified and otherwise-accredited agency providers must, upon ODM request, make available within ten business days all review reports and accepted plans of correction from their certification/accreditation bodies.(Rule 5160-45-06 | ODM-administered waiver program: structural reviews of providers and investigation of provider occurrences)
• 6Non-medicare-certified agency providers are subject to structural reviews by ODM or its designee every two years after beginning billable services.(Rule 5160-45-06 | ODM-administered waiver program: structural reviews of providers and investigation of provider occurrences)