Ohio Administrative Code Search
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Rule 5160-26-01 | Managed care: definitions.
... means the record containing demographic health-related information provided by an eligible individual, managed care member, or ODM that is used by the Ohio medicaid consumer hotline to process membership transactions. (H) "Coordination of benefits (COB)" means a procedure establishing the order in which health care entities pay their claims as described in rule 5160-26-09.1 of the Administrative... |
Rule 5160-26-05 | Managed care: provider network and contracting requirements.
...es of protected health information (PHI). (24) A specification that any third party administrator (TPA) must include the elements of paragraph (D) of this rule in its contracts and ensure that its contracted providers will forward information to ODM as requested. (25) A specification that home health providers must meet the eligible provider requirements specified in Chapter 5160-12 of the A... |
Rule 5160:1-1-01 | Medicaid: definitions.
...ctronic protected health information" (ePHI) means any protected health information (PHI) that is maintained or transmitted in electronic form, regardless of the format. (19) "Electronic signature" has the same meaning as in section 1306.01 of the Revised Code. (20) "Erroneous payment" means a medicaid reimbursement made for an individual who was ineligible at the time services were received, regardless of the pres... |
Rule 5160:1-1-01 | Medicaid: definitions.
...nic protected health information" (ePHI) means any protected health information (PHI) that is maintained or transmitted in electronic form, regardless of the format. (22) "Electronic signature" means an electronic sound, symbol, or process attached to, or logically associated with, a record and executed or adopted by a person with the intent to sign the record as defined in section 1306.01 of... |
Rule 5160:1-1-01 | Medicaid: definitions.
...nic protected health information" (ePHI) means any protected health information (PHI) that is maintained or transmitted in electronic form, regardless of the format. (22) "Electronic signature" means an electronic sound, symbol, or process attached to, or logically associated with, a record and executed or adopted by a person with the intent to sign the record as defined in section 1306.01 of... |
Rule 5160:1-2-05 | Medicaid: notice of privacy practices.
...osures of protected health information (PHI) the administrative agency is permitted with examples for each of the following purposes: (i) Payment; (ii) Treatment; and (iii) Healthcare operations. (b) A description of the uses and disclosures permitted without the individual's written consent or authorization; (c) A statement that other uses and disclosures will be made only with the individual's written authoriz... |
Rule 5160:1-2-15 | Medicaid: Healthchek (Early and Periodic Screening, Diagnostic and Treatment Services).
...the family's new address. (v) In geographic areas with Ohio childhood lead poisoning prevention regional resource centers or local arrangements for environmental assessments and follow-up, the requirements of those programs supersede this rule. (3) CDJFS healthchek services implementation plan (HSIP) ODM 03517 (rev. 07/2016). Each CDJFS is required to have a healthchek services implementat... |
Rule 5160:1-2-16 | Medicaid: pregnancy related services (PRS).
...or Use of Protected Health Information (PHI) or Other Confidential Information" (rev. 8/2014), when additional medical information is needed from the individual. (10) Maintain a listing of fee-for-service providers who have expressed a willingness to furnish non-medicaid covered services at little or no expense to the individual. It is recognized that the ability of the administrative agency to recruit and maintain ... |
Rule 5160:1-3-02.9 | Medicaid: disability determination process.
...se of Protected Health Information (PHI)" (rev. 2/2016) from the individual for all providers who have or may have current medical information. (10) Complete the JFS 03605 "CDJFS Referral to DDU" (rev. 6/2006) using current medical information. (11) Submit the disability packet to the DDA for a blindness or disability determination. (12) When the DDA has deferred a disability determina... |