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This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and universities.

Ohio Administrative Code Search

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Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.

...(A) RSS provides cash assistance to aged, blind, or disabled adults who are eligible for medical assistance and who have increased needs due to a medical condition which is not severe enough to require institutionalization. The RSS cash payment is used together with the individual's income to help prevent institutionalization and to deinstitutionalize those aged, blind, or disabled adults who have...

Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.

...(A) RSS provides cash assistance to aged, blind, or disabled adults who are eligible for medical assistance and who have increased needs due to a medical condition which is not severe enough to require institutionalization. The RSS cash payment is used together with the individual's income to help prevent institutionalization and to deinstitutionalize those aged, blind, or disabled adults who have...

Rule 5160:1-5-01 | Medicaid: the residential state supplement (RSS) program.

...(A) RSS provides cash assistance to aged, blind, or disabled adults who are eligible for medical assistance and who have increased needs due to a medical condition which is not severe enough to require institutionalization. The RSS cash payment is used together with the individual's income to help prevent institutionalization and to deinstitutionalize those aged, blind, or disabled adults who have...

Rule 5160:1-5-02 | Medicaid: breast and cervical cancer project (BCCP).

...(A) This rule describes the medicaid breast and cervical cancer project. (B) The rules in Chapter 5160:1-5 of the Administrative Code set forth the eligibility requirements for participation in the breast and cervical cancer project. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 (BCCPTA), in accordance with Pub. L. No. 106-354 and 42 U.S.C. 1396a(a)(10)(A)(ii) (as in effect ...

Rule 5160:1-5-02 | Medicaid: breast and cervical cancer project (BCCP).

...(A) This rule describes the medicaid breast and cervical cancer project. (B) Rules 5160:1-5-02 to 5160:1-5-02.4 of the Administrative Code set forth the eligibility requirements for participation in the breast and cervical cancer project. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 (BCCPTA), in accordance with Pub. L. No. 106-354 and 42 U.S.C. 1396a(a)(10)(A)(ii) (as in ef...

Rule 5160:1-5-02.1 | Medicaid: breast and cervical cancer project (BCCP) definitions.

...(A) This rule contains definitions generally used for BCCP. (B) Definitions. (1) "Breast and Cervical Cancer Project (BCCP) medicaid" means the category of medicaid for qualified individuals in need of treatment for breast or cervical cancer, including pre-cancerous conditions and early stage cancer. BCCP medicaid is administered by the Ohio department of medicaid (ODM) in coordination with the ...

Rule 5160:1-5-02.1 | Medicaid: breast and cervical cancer project (BCCP) definitions.

...(A) This rule contains definitions generally used for BCCP. (B) Definitions. (1) "Breast and Cervical Cancer Project (BCCP) medicaid" means the category of medicaid for qualified individuals in need of treatment for breast or cervical cancer, including pre-cancerous conditions and early stage cancer. BCCP medicaid is administered by the Ohio department of medicaid (ODM) in coordination with the ...

Rule 5160:1-5-02.2 | Medicaid: breast and cervical cancer project (BCCP): eligibility requirements.

...(A) This rule describes the eligibility criteria for BCCP medicaid. (B) An individual shall meet all of the following criteria to be eligible for BCCP medicaid: (1) Be screened for breast or cervical cancer under the national breast and cervical cancer early detection program (NBCCEDP). (a) An individual is not required to obtain screening for both breast and cervical cancer as a condition of e...

Rule 5160:1-5-02.2 | Medicaid: breast and cervical cancer project (BCCP): eligibility requirements.

...(A) This rule describes the eligibility criteria for BCCP medicaid. (B) An individual shall meet all of the following criteria to be eligible for BCCP medicaid: (1) Be screened for breast or cervical cancer under the national breast and cervical cancer early detection program (NBCCEDP). (a) An individual is not required to obtain screening for both breast and cervical cancer as a condition of e...

Rule 5160:1-5-02.4 | Medicaid: breast and cervical cancer project (BCCP): application and renewal process.

...(A) This rule describes the application and renewal process for the breast and cervical cancer project (BCCP). (B) The BCCP medicaid application and renewal process shall: (1) Be coordinated between Ohio department of medicaid (ODM), Ohio department of health (ODH) BCCP, and ODH BCCP designated local agencies and/or subgrantees, (2) Be coordinated with ODH BCCP case management services, and...

Rule 5160:1-5-02.4 | Medicaid: breast and cervical cancer project (BCCP): application and renewal processes.

...(A) This rule describes the application and renewal process for the breast and cervical cancer project (BCCP). (B) The BCCP medicaid application and renewal process shall: (1) Be coordinated between the Ohio department of medicaid (ODM), Ohio department of health (ODH) BCCP, and ODH BCCP designated local agencies and/or subgrantees, (2) Be coordinated with ODH BCCP case management services,...

Rule 5160:1-5-03 | Medicaid: medicaid buy-in for workers with disabilities (MBIWD).

...(A) This rule governs the eligibility requirements for the medical assistance programs authorized under sections 1902(a)(10)(A)(ii)(XV) and (XVI) of the Social Security Act (as in effect October 1, 2019). Medicaid buy-in for workers with disabilities (MBIWD) enables certain individuals to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. ...

Rule 5160:1-5-03 | Medicaid: medicaid buy-in for workers with disabilities (MBIWD).

...(A) This rule governs the eligibility requirements for the medical assistance programs authorized under sections 1902(a)(10)(A)(ii)(XV) and (XVI) of the Social Security Act (as in effect October 1, 2024). Medicaid buy-in for workers with disabilities (MBIWD) enables certain individuals to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. ...

Rule 5160:1-5-04 | Medicaid: Ohio workability.

...(A) This rule governs the eligibility requirements for the medical assistance program authorized under section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act (as in effect October 1, 2024). Ohio workability enables certain working disabled individuals aged sixty-five or older to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. (1) ...

Rule 5160:1-5-04 | Medicaid: Ohio workability.

...(A) This rule governs the eligibility requirements for the medical assistance program authorized under section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act (as in effect October 1, 2024). Ohio workability enables certain working disabled individuals aged sixty-five or older to increase their income and resources without the risk of losing medical assistance coverage. (B) Definitions. (1) ...

Rule 5160:1-5-05 | Medicaid: refugee medical assistance (RMA).

...(A) This rule describes a time-limited medical assistance program, funded through the office of refugee resettlement (ORR), that provides a medical screening through contracted refugee health screening providers and other medical services. There is no resource limit for an individual described in this rule. (B) Definitions. (1) "Countable income," for the purpose of this rule, has the same meani...

Rule 5160:1-5-05 | Medicaid: refugee medical assistance (RMA).

...(A) This rule describes a time-limited medical assistance program, funded through the office of refugee resettlement (ORR), that provides a medical screening through contracted refugee health screening providers and other medical services. There is no resource limit for an individual described in this rule. (B) Definitions. (1) "Countable income," for the purpose of this rule, has the same meani...

Rule 5160:1-5-06 | Medicaid: non-citizen emergency medical assistance (NCEMA).

...(A) In accordance with 42 U.S.C. 1396b(v), this rule describes eligibility criteria for coverage of the treatment of an emergency medical condition for certain individuals who do not meet the medicaid citizenship or satisfactory immigration status requirements described in rule 5160:1-2-11 or 5160:1-2-12 of the Administrative Code. (B) Definition. "Emergency medical condition," for the purpos...

Rule 5160:1-5-07 | Medicaid: specialized recovery services (SRS) program.

...(A) This rule sets forth the eligibility criteria for a state plan home and community-based services (HCBS) benefit authorized under section 1915(i) of the Social Security Act (as in effect on October 1, 2017). Section 1915(i) of the act allows states the flexibility to provide HCBS to individuals who require less than an institutional level of care (LOC) and who would, therefore, not be eligible ...

Rule 5160:1-5-07 | Medicaid: specialized recovery services (SRS) program.

...(A) This rule sets forth the eligibility criteria for a state plan home and community-based services (HCBS) benefit authorized under section 1915(i) of the Social Security Act (as in effect October 1, 2024). Section 1915(i) allows states the flexibility to provide HCBS to individuals who require less than an institutional level of care (LOC) and who would, therefore, not be eligible for HCBS under...

Rule 5160:1-5-08 | Medicaid: state-funded medical assistance for non-citizen victims of trafficking.

...(A) This rule describes the eligibility requirements for state-funded medical assistance for a non-citizen victim of a severe form of human trafficking. Eligibility for this program shall be determined for applications for medical assistance filed on or after the effective date of this rule. (B) For purposes of this rule the following definitions apply unless otherwise stated. (1) "Labor traffic...

Rule 5160:1-5-08 | Medicaid: state-funded medical assistance for non-citizen victims of trafficking.

...(A) This rule describes the eligibility requirements for state-funded medical assistance for a non-citizen victim of a severe form of human trafficking. (B) For purposes of this rule the following definitions apply unless otherwise stated. (1) "Labor trafficking" means recruiting, harboring, transporting, or obtaining of a person for labor or services through the use of force, fraud, or intimida...

Rule 5160:1-6-01 | Medicaid: eligibility for medicaid payment for long-term care (LTC) services.

...(A) This rule describes how an individual is determined eligible for medicaid payment for long-term care (LTC) services. (B) Before an individual can receive medicaid payment for LTC services, the individual must: (1) Be eligible for medical assistance in accordance with Chapter 5160:1-3, 5160:1-4, 5160:1-5, or 5160:1-6, as applicable; and (2) Meet any non-financial eligibility requirements required for the type o...

Rule 5160:1-6-01 | Medicaid: eligibility for medicaid payment for long-term care (LTC) services.

...(A) This rule describes how an individual is determined eligible for medicaid payment for long-term care (LTC) services. (B) In order to receive medicaid payment for LTC services, the individual must: (1) Be eligible for medical assistance in accordance with Chapter 5160:1-3, 5160:1-4, 5160:1-5, or 5160:1-6, as applicable; and (2) Meet any non-financial eligibility requirements for the type...

Rule 5160:1-6-01.1 | Medicaid: definitions relating to eligibility for long-term care services.

...(A) For purposes of this chapter the following definitions apply unless otherwise stated. (1) "Baseline date" means the first date the individual both is an institutionalized individual and has applied for medical assistance. An individual only has one baseline date. (2) "Community spouse" (CS) means an individual who is not receiving medicaid payment for long-term care (LTC) services and is married to an instituti...