Ohio Administrative Code
Title 3701 - Department of Health - Administration and Director
Chapter 3701-43 - Program for Medically Handicapped Children
Section 3701-43-11 - Application and eligibility for provision of diagnostic services

(A) Application for provision of diagnostic services as defined in paragraph (D) rule 3701-43-01 of the Administrative Code requires the following:

(B) Subject to paragraph (C) of this rule, an applicant is eligible for diagnostic services if based on information submitted pursuant to paragraph (A) of this rule the director determines that the applicant is in need of diagnostic services to determine whether or not the applicant has a medically handicapping or potentially medically handicapping condition.

(C) Notwithstanding paragraph (B) of this rule, the director may determine that the applicant is not in need of diagnostic services necessary to determine whether or not he has a medically handicapping or potentially medically handicapping condition if either of the following apply:

(D) If the completed medical application is received by the director within sixty days of the date of initial examination by the managing physician, eligibility for diagnostic services shall be effective no earlier than the initial date of examination by the managing physician.

(E) Based on the type and number of services requested on the managing physician's individual plan for diagnostic services, the director shall establish for each eligible recipient a period of eligibility for payment of diagnostic services which shall not exceed one hundred eighty days from the effective date of eligibility.

(F) The director shall notify the applicant or his or her parent, guardian or other legal representative, selected providers of major services, the local health department and the managing physician of the approval or proposed denial of eligibility and the effective date of eligibility, if approved. The director shall issue this notification within sixty days of the date of receipt of the last document necessary to make the eligibility determination or of the failure to submit timely an application or requested additional information. A notice of proposed denial of eligibility shall contain a statement of the reasons for denial and a description of the reconsideration procedure established by paragraph (B) of rule 3701-43-23 of the Administrative Code.