As part of the ongoing rule-review process, two State Hearings/Notice rules have been updated. The changes made to these two rules are very minor and consist only of removing references to "ODHS," and changing agency references to reflect the current name, "ODJFS" and correcting the reference to county agencies as "CDJFS" rather than "CDHS."

A change has been made to more clearly identify the office to which Managed Health Care-related notices should be sent. There has also been a minor change made to align the rule with the current notice requirements contained in the Managed Health Care program.

Also included in this package are printed copies of the interactive notices ODJFS provides for use to Managed Care Plans. The form numbers have been changed to reflect current policy and the agency name. We have also revised the Explanation of State Hearings, JFS 04059 (formerly the ODHS 4059), so that the current toll-free number is listed.

INSTRUCTIONS:

In Chapter 1000, State Hearings, please do the following:

Remove and file as obsolete OAC rule 5101:6-2-35, "Notice of a Managed Care plan's denial, reduction or termination of a medicaid-covered service" effective December 19, 1997, and replace with the corresponding rule, effective October 1, 2002.

Remove and file as obsolete OAC rule 5101:6-2-32, "Notice of adverse preadmission screening and resident review (PASRR) determinations" effective June 1, 1997, and replace with the corresponding rule, effective October 1, 2002.

In the Appendix, of the State Hearings Manual, please do the following:

Remove and file as obsolete the ODHS 4043, Notice of Denial, Reduction or Termination of Medical Services by your Managed Care Plan, and replace with the attached JFS 04043.

Remove and file as obsolete the ODHS 4046, Notice of Denial of Payment for Medical Services by Your Managed Care Plan, and replace with the attached JFS 04046.

Remove and file as obsolete the ODHS 4059, Explanation of State Hearing Procedures, and replace with the corresponding JFS 04059.