Ohio Administrative Code Search

...(A) The following standards are mandatory: (1) A detention center shall follow the bureau of criminal identification (BCII) and investigation process to conduct a criminal record check with respect to any prospective employee who has applied to the detention center for appointment or employment. (2) The detention center shall inform each prospective employee at the time of initial applicatio...

...The following standards are mandatory: (A) Written policy and procedure on physical force shall: (1) Limit the use of physical force to protect the child from harming himself, herself, or others, to stop a child who presents a danger of escape, to remove a child from the general population if the child is disrupting operations, or engaging in property destruction that involves a threat to the ch...

...The following standards are mandatory: (A) Written policy and procedure on physical force shall: (1) Limit the use of physical force to protect the child from harming himself, herself, or others, to stop a child who presents a danger of escape, to remove a child from the general population if the child is disrupting operations, or engaging in property destruction that involves a threat to the ch...

...The juvenile court shall: (A) Submit a signed grant agreement and funding application by a date determined by the department; (B) Submit financial expenditure reports, other fiscal reports, program reports, statistical reports, and other information on forms and according to the time frame established by the department; (C) Deposit grant funds into the felony delinquent care and custody fund; ...

...The department and the county shall adhere to the following: (A) Each county receiving grant funds shall in writing request the auditor of state, or an accounting firm authorized by the auditor of state, to perform additional procedures as part of the audit performed under section 117.11 of the Revised Code. The cost of performing the additional audit procedures shall be paid from the felony delinquent care and cust...

...(A) The maximum balance carry over at the end of each respective fiscal year in the felony delinquent care and custody fund in any county, from funds allocated to the county pursuant to sections 5139.34 and 5139.41 of the Revised Code in previous years, shall not exceed an amount to be calculated as provided in the formula set forth in section 5139.43 of the Revised Code, unless that county has applied by the due dat...

...The purpose of this rule is to provide consistent guidelines and criteria on the release authority regular release review process. (A) All youth shall receive a release review at least thirty days prior to their MSED, unless a youth has a significant amount of confinement credit, a commitment change or a revocation which prohibits conducting the review within that time frame (section 5139.56 of ...

...The purpose of this rule is to provide consistent guidelines and criteria on the release authority semi-annual review process for long term youth. (A) Youth committed to the department with minimum sentences, minus confinement credit, greater than twelve months may be scheduled for semi-annual reviews. (B) A release authority designee may meet with the youth, institutional representatives, regiona...

...The purpose of this rule is to provide consistent guidelines and criteria on the release authority revocation review process. (A) Youth returning to the department from either a judicial release to probation (division (B)(1) of section 2152.22 of the Revised Code) or a judicial release to parole (divisions (B)(2), (C)(1) and (D)(2) of section 2152.22 of the Revised Code) from a revocation shall have...

...This rule describes general principles regarding reimbursement of services by medicaid. Reimbursement may be subject to additional administrative criteria as described in agency 5160 of the Administrative Code. (A) A medical service is reimbursable if: (1) The service is determined medically necessary as defined in rule 5160-1-01 of the Administrative Code. (2) The service is agreed to by the...

...(A) Definitions. For the purposes of rules promulgated by this agency in accordance with section 1347.15 of the Revised Code effective April 9, 2009, the following definitions apply: (1) "Access" as a noun means an instance of copying, viewing, or otherwise perceiving; whereas, "access" as a verb means to copy, view, or otherwise perceive. (2) "Acquisition of a new computer system" means th...

...Paragraphs (A)(7) to (F)(4) of this rule do not apply to pharmacy services covered under the medicare part D program. Pharmacy services covered under the medicare part D program should be billed in accordance with rule 5160-9-06 of the Administrative Code. (A) Definitions. (1) "Medicare" is a federally financed program of hospital insurance (part A) and supplemental medical insurance (also called SMI ...

...(A) For qualified medicare beneficiaries and medicaid recipients enrolled in medicare part C managed health care plans (medicare advantage plans) the department will pay as cost sharing the lesser of the following amounts: (1) The provider's billed charges for the service (except for hospital and nursing facility services); or (2) The deductible, coinsurance and co-payment amount as provided...

...(A) The reimbursement methodology set forth in paragraph (B) of this rule is limited to medicare part B services that meet all of the following criteria: (1) Are not hospital services defined in accordance with Chapter 5160-2 of the Administrative Code; (2) Are not nursing facility services included in the nursing facility per diem as defined in accordance with Chapter 5160-3 of the Administrative Code; (3) Are co...

...(A) The Ohio department of aging (ODA) is responsible for the daily administration of the preadmission screening system providing options and resources today (PASSPORT) medicaid waiver program. ODA shall administer the waiver pursuant to an interagency agreement with the Ohio department of medicaid in accordance with section 5162.35 of the Revised Code. (B) The PASSPORT waiver provides home and com...

...(A) The Ohio department of aging (ODA) is responsible for the daily administration of the preadmission screening system providing options and resources today (PASSPORT) medicaid waiver program. ODA shall administer the waiver pursuant to an interagency agreement with the Ohio department of medicaid in accordance with section 5162.35 of the Revised Code. (B) The PASSPORT waiver provides home and com...

...(A) The Ohio department of aging (ODA) is responsible for the daily administration of the preadmission screening system providing options and resources today (PASSPORT) medicaid waiver program. ODA will administer the waiver pursuant to an interagency agreement with the Ohio department of medicaid in accordance with section 5162.35 of the Revised Code. (B) The PASSPORT waiver provides home and comm...

...(A) The Ohio department of aging (ODA) is responsible for the daily administration of the assisted living HCBS waiver. ODA will administer this waiver pursuant to an interagency agreement with the Ohio department of medicaid (ODM), in accordance with section 5162.35 of the Revised Code. (B) The assisted living HCBS waiver is an alternative to nursing facility placement for persons age twenty-one ...

...(A) The Ohio department of aging (ODA) is responsible for the daily administration of the assisted living HCBS waiver. ODA will administer this waiver pursuant to an interagency agreement with the Ohio department of medicaid (ODM), in accordance with section 5162.35 of the Revised Code. (B) The assisted living HCBS waiver is an alternative to nursing facility placement for persons age twenty-one ...

...(A) The Ohio department of aging (ODA) is responsible for the daily administration of the assisted living HCBS waiver. ODA will administer this waiver pursuant to an interagency agreement with the Ohio department of medicaid (ODM), in accordance with section 5162.35 of the Revised Code. (B) The assisted living HCBS waiver is an alternative to nursing facility placement for persons age twenty-one ...

...(A) Definitions. (1) "Coordination of benefits" (COB) means the process of determining which health plan or insurance policy will pay first or determining the payment obligations of each health plan, medical insurance policy, or third party resource when two or more health plans, insurance policies or third party resources cover the same benefits for a medicaid covered individual. (2) "Coordinat...

...This rule sets forth requirements regarding co-payments by individuals for medicaid-covered services. (A) Certain medicaid services are subject to individual co-payments. Information regarding these services and co-payment amounts can be found in the following Administrative Code rules: (1) Co-payments for dental services are described in rule 5160-5-01 of the Administrative Code. (2) Co-payments for vision servic...

...(A) Out-of-state providers: (1) Should be licensed, accredited, or certified by their respective states to be considered eligible to receive reimbursement for services provided to Ohio medicaid covered individuals. (2) Should meet any standards applicable to the provision of the service in the state in which the service is being furnished, as well as those standards set forth in the Ohio med...

...(A) In accordance with 42 C.F.R. 447.15 (as in effect October 1, 2018), the medicaid payment for a covered service constitutes payment-in-full. It shall not be construed as a partial payment even when the payment amount is less than the provider's charge. (1) The provider shall not collect nor bill a medicaid recipient for any difference between the medicaid payment and the provider's charge,...

...(A) Definitions. (1) "Healthchek" is Ohio's early and periodic screening, diagnostic, and treatment (EPSDT) benefit for all medicaid recipients younger than twenty-one years of age, described in 42 U.S.C. 1396d(r) (as in effect 10/2017). (2) "Bright futures guidelines" are the American academy of pediatrics bright futures guidelines for preventive health care (rev. 2/2017), available at http://w...