Ohio · Regulations
Chapter 4123-6 — Health Partnership Program
90 sections
90 sections
- Ohio Admin. Code 4123-6-01Rule 4123-6-01. Definitions
- Ohio Admin. Code 4123-6-01.1Rule 4123-6-01.1. Applicability of medical rules
- Ohio Admin. Code 4123-6-01.2Rule 4123-6-01.2. Provisional treatment reimbursement approval -- pilot program
- Ohio Admin. Code 4123-6-02Rule 4123-6-02. Provider access to the HPP - generally
- Ohio Admin. Code 4123-6-02.2Rule 4123-6-02.2. Provider access to the HPP - provider certification criteria
- Ohio Admin. Code 4123-6-02.3Rule 4123-6-02.3. Provider access to the HPP - provider application and certification criteria
- Ohio Admin. Code 4123-6-02.4Rule 4123-6-02.4. Provider access to the HPP - provider recertification
- Ohio Admin. Code 4123-6-02.5Rule 4123-6-02.5. Provider access to the HPP - provider not certified
- Ohio Admin. Code 4123-6-02.6Rule 4123-6-02.6. Provider access to the HPP -- selection by an MCO
- Ohio Admin. Code 4123-6-02.7Rule 4123-6-02.7. Provider access to the HPP - provider decertification procedures
- Ohio Admin. Code 4123-6-02.8Rule 4123-6-02.8. Provider requirement to notify of injury
- Ohio Admin. Code 4123-6-02.9Rule 4123-6-02.9. Provider access to the HPP - provider marketing
- Ohio Admin. Code 4123-6-02.21Rule 4123-6-02.21. Provider access to the HPP - non-certified provider enrollment
- Ohio Admin. Code 4123-6-02.22Rule 4123-6-02.22. Provider access to the HPP - ambulatory surgical center arthroplasty center requirements
- Ohio Admin. Code 4123-6-02.51Rule 4123-6-02.51. Provider access to the HPP -- Denial of provider, entity or MCO enrollment or certification based on criminal conviction or civil action
- Ohio Admin. Code 4123-6-03.2Rule 4123-6-03.2. MCO participation in the HPP -- MCO application for certification or recertification
- Ohio Admin. Code 4123-6-03.4Rule 4123-6-03.4. MCO participation in the HPP - MCO certification
- Ohio Admin. Code 4123-6-03.7Rule 4123-6-03.7. MCO participation in the HPP - bureau's authority to decertify, to refuse to certify or recertify an MCO
- Ohio Admin. Code 4123-6-03.9Rule 4123-6-03.9. MCO participation in the HPP - MCO disclosure of relationship
- Ohio Admin. Code 4123-6-03.10Rule 4123-6-03.10. Conflict of interest
- Ohio Admin. Code 4123-6-04.3Rule 4123-6-04.3. MCO scope of services - MCO medical management and claims management assistance
- Ohio Admin. Code 4123-6-04.5Rule 4123-6-04.5. MCO scope of services - bureau claims management
- Ohio Admin. Code 4123-6-04.6Rule 4123-6-04.6. Return to work assessment
- Ohio Admin. Code 4123-6-05.2Rule 4123-6-05.2. Employer access to the HPP - employer enrollment and selection of MCO
- Ohio Admin. Code 4123-6-05.3Rule 4123-6-05.3. Employer access to the HPP - certain solicitation practices by MCOs prohibited
- Ohio Admin. Code 4123-6-05.4Rule 4123-6-05.4. Employer access to the HPP; payment for referrals prohibited
- Ohio Admin. Code 4123-6-06.2Rule 4123-6-06.2. Employee access to the HPP - employee choice of provider
- Ohio Admin. Code 4123-6-07Rule 4123-6-07. Services and supplies never covered
- Ohio Admin. Code 4123-6-08Rule 4123-6-08. Bureau fee schedule
- Ohio Admin. Code 4123-6-10Rule 4123-6-10. Payment to providers
- Ohio Admin. Code 4123-6-14Rule 4123-6-14. MCO bill submission to bureau
- Ohio Admin. Code 4123-6-14.1Rule 4123-6-14.1. Records to be retained by MCO
- Ohio Admin. Code 4123-6-15Rule 4123-6-15. Confidentiality of records
- Ohio Admin. Code 4123-6-16Rule 4123-6-16. Alternative dispute resolution for HPP medical issues
- Ohio Admin. Code 4123-6-16.1Rule 4123-6-16.1. HPP medical treatment guidelines
- Ohio Admin. Code 4123-6-16.2Rule 4123-6-16.2. Medical treatment reimbursement requests
- Ohio Admin. Code 4123-6-16.3Rule 4123-6-16.3. Reimbursement of retroactive medical treatment reimbursement requests
- Ohio Admin. Code 4123-6-17Rule 4123-6-17. Bureau refusal to certify or recertify, action to decertify a provider or MCO - standards and procedures for adjudication hearings
- Ohio Admin. Code 4123-6-18Rule 4123-6-18. Data gathering and reporting
- Ohio Admin. Code 4123-6-19Rule 4123-6-19. Remain at work services
- Ohio Admin. Code 4123-6-20Rule 4123-6-20. Obligation to submit medical documentation and reports
- Ohio Admin. Code 4123-6-20.1Rule 4123-6-20.1. Access to medical documentation
- Ohio Admin. Code 4123-6-21Rule 4123-6-21. Payment for outpatient medication
- Ohio Admin. Code 4123-6-21.1Rule 4123-6-21.1. Payment for outpatient medication by self-insuring employer
- Ohio Admin. Code 4123-6-21.2Rule 4123-6-21.2. Pharmacy and therapeutics committee
- Ohio Admin. Code 4123-6-21.3Rule 4123-6-21.3. Outpatient medication formulary
- Ohio Admin. Code 4123-6-21.4Rule 4123-6-21.4. Coordinated services program
- Ohio Admin. Code 4123-6-21.5Rule 4123-6-21.5. Standard dose tapering schedules
- Ohio Admin. Code 4123-6-21.6Rule 4123-6-21.6. First fill of outpatient medications
- Ohio Admin. Code 4123-6-21.8Rule 4123-6-21.8. Reimbursement for services to assist in the discontinuation of medications
- Ohio Admin. Code 4123-6-22Rule 4123-6-22. Stakeholders' health care quality assurance advisory committee
- Ohio Admin. Code 4123-6-25Rule 4123-6-25. Payment for medical supplies and services
- Ohio Admin. Code 4123-6-26Rule 4123-6-26. Claimant reimbursement
- Ohio Admin. Code 4123-6-27Rule 4123-6-27. Treatment by more than one physician
- Ohio Admin. Code 4123-6-29Rule 4123-6-29. Request for information by the treating provider
- Ohio Admin. Code 4123-6-30Rule 4123-6-30. Payment for physical medicine
- Ohio Admin. Code 4123-6-31Rule 4123-6-31. Payment for miscellaneous medical services and supplies
- Ohio Admin. Code 4123-6-31.1Rule 4123-6-31.1. Supportive care
- Ohio Admin. Code 4123-6-32Rule 4123-6-32. Payment for lumbar fusion surgery
- Ohio Admin. Code 4123-6-33Rule 4123-6-33. Payment for health behavior assessment and intervention services
- Ohio Admin. Code 4123-6-34Rule 4123-6-34. Payment for treatment of concussion injuries
- Ohio Admin. Code 4123-6-35Rule 4123-6-35. Payment for spinal cord stimulator
- Ohio Admin. Code 4123-6-36Rule 4123-6-36. Enhanced care program
- Ohio Admin. Code 4123-6-37Rule 4123-6-37. Payment of hospital bills
- Ohio Admin. Code 4123-6-37.1Rule 4123-6-37.1. Payment of hospital inpatient services
- Ohio Admin. Code 4123-6-37.2Rule 4123-6-37.2. Payment of hospital outpatient services
- Ohio Admin. Code 4123-6-37.3Rule 4123-6-37.3. Payment of ambulatory surgical center services
- Ohio Admin. Code 4123-6-38Rule 4123-6-38. Payment for home health nursing services and home health aide services
- Ohio Admin. Code 4123-6-38.1Rule 4123-6-38.1. Payment for nursing and caregiver services provided by persons other than home health agency employees
- Ohio Admin. Code 4123-6-38.2Rule 4123-6-38.2. Payment of nursing home and residential care/assisted living services
- Ohio Admin. Code 4123-6-39Rule 4123-6-39. Payment for prosthetic device or other artificial appliances
- Ohio Admin. Code 4123-6-40Rule 4123-6-40. Payment of claimant travel expenses
- Ohio Admin. Code 4123-6-41Rule 4123-6-41. No legal relationship between the industrial commission or bureau and a health care provider
- Ohio Admin. Code 4123-6-42Rule 4123-6-42. Interest on late payments for equipment, materials, goods, supplies or services in state insurance fund, public work relief employees' compensation fund, coal workers pneumoconiosis fund, and marine industry fund claims
- Ohio Admin. Code 4123-6-43Rule 4123-6-43. Payment for transcutaneous electrical nerve stimulators and neuromuscular electrical stimulators
- Ohio Admin. Code 4123-6-44Rule 4123-6-44. Bureau fees for provider services rendered by in-state and out-of-state providers
- Ohio Admin. Code 4123-6-45Rule 4123-6-45. Audit of providers' patient and billing related records
- Ohio Admin. Code 4123-6-45.1Rule 4123-6-45.1. Records to be retained by provider
- Ohio Admin. Code 4123-6-46Rule 4123-6-46. Standardized or negotiated payment rates for services or supplies
- Ohio Admin. Code 4123-6-51Rule 4123-6-51. Employer participation in the QHP system - bureau certification of QHPs
- Ohio Admin. Code 4123-6-52Rule 4123-6-52. Employer participation in the QHP system - bureau recertification of QHPs
- Ohio Admin. Code 4123-6-53Rule 4123-6-53. Employer participation in the QHP system - QHP quality assurance program required
- Ohio Admin. Code 4123-6-54Rule 4123-6-54. Employer participation in the QHP system - QHP certification application
- Ohio Admin. Code 4123-6-55Rule 4123-6-55. Employer participation in the QHP system - bureau's authority to decertify, to refuse to certify or recertify a QHP
- Ohio Admin. Code 4123-6-58Rule 4123-6-58. Provider access to the QHP system - provider participation in QHP system and other related health care program not linked
- Ohio Admin. Code 4123-6-59Rule 4123-6-59. Provider access to the QHP system - QHP provider selection
- Ohio Admin. Code 4123-6-65Rule 4123-6-65. Payment in the QHP system - employer payment to vendor that provides medical management and cost containment services and/or QHPs
- Ohio Admin. Code 4123-6-69Rule 4123-6-69. QHP dispute resolution process
- Ohio Admin. Code 4123-6-70Rule 4123-6-70. Evaluation of the QHP system by the bureau; reporting requirements by employers and QHPs
- Ohio Admin. Code 4123-6-72Rule 4123-6-72. Confidentiality