Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-15 - Medical Transportation Services
Section 5160-15-14 - Transportation: non-emergency services through a CDJFS: program integrity provisions
Universal Citation: OH Admin Code 5160-15-14
Current through all regulations passed and filed through September 16, 2024
(A) Definitions.
(1) "Private transportation vendor (PTV)" is
an entity that meets the following criteria:
(a) It seeks to establish or to maintain a
contract with a county department of job and family services (CDJFS) to supply
transportation service to medicaid recipients in accordance with rule
5160-15-10 of the Administrative
Code; and
(b) It is not a
government agency, transit authority, public transportation system, or other
quasi-governmental organization.
(2) "PTV owner/manager" is a person having an
ownership or control interest in the PTV, as defined in
42
C.F.R. 455.101 (October 1, 2020).
(3) "Related enterprise" is any other
business in which a PTV owner/manager has an ownership or control
interest.
(4) "Direct-service PTV
employee" is a PTV employee who provides direct services to medicaid
recipients.
(B) A CDJFS may hold a contract with a PTV only if the following conditions are met:
(1) All applicable disclosure provisions set
forth in 42 C.F.R. Part 455, Subpart B (October 1, 2020) are
satisfied;
(2) Whenever a contract
between the CDJFS and the PTV is established or renewed and whenever the PTV is
considering an applicant for a position as a directservice PTV employee, the
following
four conditions are met:
(a)
Each driver
holding or applying for a position with the PTV has a valid driver's
license;
(b)
For each driver holding or applying for a position with
the PTV, a certified driving record history is obtained from the bureau of
motor vehicles of the Ohio department of public safety and provided to the
CDJFS;
(c) A criminal
background check performed in accordance with section
109.572 of the Revised Code on
each direct-service PTV employee or applicant returns one of two results:
(i) The direct-service PTV employee or
applicant has never been convicted of or pleaded guilty to an offense listed in
divisions (A)(3)(a) to (A)(3)(e) of section
109.572 of the Revised Code (a
disqualifying offense); or
(ii) The
direct-service PTV employee or applicant has been convicted of or pleaded
guilty to a disqualifying offense and one of the following criteria is met:
(a) The individual has satisfied the
conditions associated with any applicable exclusionary periods set forth in
rule 5160-1- 17.8 of the Administrative Code; or
(b) The individual has obtained a certificate
of qualification for employment in accordance with section
2953.25 of the Revised Code or
an equivalent certification issued by another state or federal jurisdiction;
and
(d) A search
substantiates that no PTV, PTV owner/manager, or directservice PTV employee or
applicant is currently listed as sanctioned or excluded in either of the
following databases:
(i) The system for award
management (SAM) maintained by the United States general services
administration; or
(ii) The list of
excluded individuals and entities (LEIE) maintained by the office of inspector
general in the United States department of health and human services.
(C) Not later than thirty calendar days either after a contract period has started or after a criminal background check and database search have been performed for an applicant, the CDJFS documents and submits to the department or its designee the relevant information indicated in paragraph (B) of this rule, in the format specified by the department or its designee.
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