§ 5167.16 — Home visits and cognitive behavioral therapy

Ohio § 5167.16

• Jurisdiction: Ohio
• Title 51: Public Welfare
• Ch. 5167: Medicaid Managed Care

Text

(A) As used in this section:

(1) "Help me grow program" means the program established by the department of health pursuant to section5180.21of the Revised Code.

(2) "Targeted case management" has the same meaning as in 42 C.F.R. 440.169(b).

(B) A medicaid managed care organization shall provide to a medicaid recipient who meets the criteria in division (C) of this section, or arrange for such recipient to receive, both of the following types of services:

(1) Home visits, which shall include depression screenings, for which federal financial participation is available under the targeted case management benefit;

(2) Cognitive behavioral therapy, provided by a community mental health services provider, that is determined to be medically necessary through a depression screening conducted as part of a home visit.

(C) A medicaid recipient qualifies to receive the services specified in division (B) of this section if the medicaid recipient is enrolled in the help me grow program, enrolled in the medicaid managed care organization providing or arranging for the services, and is either pregnant or the birth mother of a child under five years of age.

(D) If requested by a medicaid recipient eligible for the cognitive behavioral therapy covered under division (B)(2) of this section, the therapy shall be provided in the recipient's home. The medicaid managed care organization shall inform the medicaid recipient of the right to make the request and how to make it.

Last updated August 7, 2025 at 1:34 PM

Legislative History

Effective: January 1, 2025 | Latest Legislation: House Bill 33 - 135th General Assembly