Ohio Revised Code Search

...To be eligible for funds from the subsidy programs established under division (A)(1) of section 5149.31 of the Revised Code, a municipal corporation, county, or group of counties shall comply with all of the following that are relevant: (A) Maintain programs that meet the standards adopted under division (A)(2) of section 5149.31 of the Revised Code; (B) Demonstrate that it has made efforts to unify or coordi...

...(A) In each voluntary county, subject to division (B) of this section and not later than the deadlines established by the department of rehabilitation and correction in division (B)(3)(b)(ii) of section 2929.34 of the Revised Code, a county commissioner representing the board of county commissioners of the county, the administrative judge of the general division of the court of common pleas of the county, the sheriff...

...(A) The board of county commissioners or operator shall do either of the following: (1) Appoint a superintendent or administrator of the county home; (2) In accordance with section 5155.012 of the Revised Code, enter into a contract with a public or private entity that agrees to select a superintendent or administrator with the advice and consent of the board. (B) The superintendent or administrator may reside on ...

...The superintendent or administrator or, if operational control has been transferred to an operator under section 5155.011 of the Revised Code, the operator of the county home shall submit to the board of county commissioners an annual report. The report shall show all of the following: (A) The number of residents at the beginning of the year, the number admitted during the year, the number born in the home, and the ...

...The board of county commissioners or the operator may require the superintendent or administrator of the county home to submit to the board of county commissioners and, if applicable, to the operator a monthly report . The monthly report may contain any or all of the following: (A) The number of residents at the beginning of each month; (B) The number of residents admitted during the month; (C) The number of resid...

...(A) As used in this section: (1) "Nursing facility" has the same meaning as in section 5165.01 of the Revised Code. (2) "PASRR" means the preadmission screening and annual resident review of individuals with mental illnesses and intellectual disabilities required by the "Social Security Act," 42 U.S.C. 1396r(e)(7). (B) A county home or district home that is a nursing facility may provide sub-acute detoxifica...

...As used in this chapter: (A) "Dual eligible individual" has the same meaning as in the "Social Security Act," section 1915(h)(2)(B), 42 U.S.C. 1396n(h)(2)(B). A dual eligible individual is a medicare-medicaid enrollee (MME). (B) "Exchange" has the same meaning as in 45 C.F.R. 155.20. (C) "Federal financial participation" means the federal government's share of expenditures made by an entity in implementing a medic...

...(A) As used in this section, "entity" includes an agency, board, commission, or department of the state or a political subdivision of the state; a private, nonprofit entity; a school district; a private school; or a public or private institution of higher education. (B) This section does not apply to contracts entered into under section 5162.32 or 5162.35 of the Revised Code. (C) At the request of any public ...

...The department of medicaid may appoint and commission any competent person to serve as a special agent, investigator, or representative to perform a designated duty for and on behalf of the department. Specific credentials shall be given by the department to each person so designated, and each credential shall state the following: (A) The person's name; (B) The agency with which the person is connected; (C) ...

...As used in sections 5160.35 to 5160.43 of the Revised Code: (A) "Information" means all of the following: (1) An individual's name, address, date of birth, and social security number; (2) The group or plan number, or other identifier, assigned by a third party to a policy held by an individual or a plan in which the individual participates and the nature of the coverage; (3) Any other data the medicaid di...

...(A) A third party shall cooperate with the department of medicaid in identifying individuals for the purpose of establishing third party liability regarding medical assistance programs. (B) In furtherance of the requirement in division (A) of this section and to allow the department to determine any period that the individual or the individual's spouse or dependent may have been covered by the third party and...

...(A) As used in this section, "business day" means any day of the week excluding Saturday, Sunday, and a legal holiday, as defined in section 1.14 of the Revised Code. (B) Subject to divisions (C) and (D) of this section, a third party shall do all of the following: (1) Accept the department of medicaid's right of recovery under section 5160.37 of the Revised Code and the assignment of rights to the department t...

...For the purpose of the "Social Security Act," section 1902(a)(5), 42 U.S.C. 1396a(a)(5), the department of medicaid shall act as the single state agency to supervise the administration of the medicaid program. As the single state agency, the department shall comply with 42 C.F.R. 431.10(e) and all other federal requirements applicable to the single state agency.

...The medicaid program shall be implemented in accordance with all of the following: (A) The medicaid state plan approved by the United States secretary of health and human services, including amendments to the plan approved by the United States secretary; (B) Federal medicaid waivers granted by the United States secretary, including amendments to waivers approved by the United States secretary; (C) Other type...

...The medicaid director shall seek federal approval for all components, and aspects of components, of the medicaid program for which federal approval is needed, except that the director is permitted rather than required to seek federal approval for components, and aspects of components, that state statutes permit rather than require be implemented. Federal approval shall be sought in the following forms as approp...

...Not less than once each year, the medicaid director shall submit a report on the medicaid buy-in for workers with disabilities program to the governor and the general assembly. The copy to the general assembly shall be submitted in accordance with section 101.68 of the Revised Code. The report shall include all of the following information: (A) The number of individuals who participated in the medicaid buy-in for ...

...(A) The department of medicaid shall institute cost-sharing requirements for the medicaid program. The department shall not institute cost-sharing requirements in a manner that does either of the following: (1) Disproportionately impacts the ability of medicaid recipients with chronic illnesses to obtain medically necessary medicaid services; (2) Violates section 5164.09 or 5164.10 of the Revised Code. (B)(1) N...

...(A) The medicaid director shall adopt rules under section 5162.02 of the Revised Code permitting county departments of job and family services to take action to recover benefits incorrectly paid on behalf of medicaid recipients. The rules shall provide for recovery by the following methods: (1) Soliciting voluntary payments from recipients or from persons holding property in which a recipient has a legal or e...

...(A) As used in this section: (1) "State directed payment program" means a payment program authorized by the United States centers for medicare and medicaid services under 42 C.F.R. 438.6(c). (2) "Preprint" means a form created by the United States centers for medicare and medicaid services to request approval of a state directed payment program, as required under 42 C.F.R. 438.6(c). (B)(1) Except as provided in...

...(A) The general assembly hereby finds that the state has an insurable interest in medicaid recipients because of the state's statutory right to recover from the estate of a recipient state funds used to provide the recipient with medicaid services. (B) As used in this section: (1) "Beneficiary" means the person or entity designated in a life insurance policy to receive the proceeds of the policy on the death...

...(A) The department of medicaid shall do all of the following with regard to the application procedures for the healthy start component of the medicaid program: (1) Establish a short application form for the component that requires the applicant to provide no more information than is necessary for making determinations of eligibility for the component, except that the form may require applicants to provide the...

...As used in this chapter: (A) "Adjudication" has the same meaning as in section 119.01 of the Revised Code. (B) "Behavioral health redesign" means revisions to the medicaid program's coverage of community behavioral health services beginning July 1, 2017, including revisions that update medicaid billing codes and payment rates for community behavioral health services. (C) "Clean claim" has the same meaning as in...

...(A) As used in this section: (1) "Screening mammography" means a radiologic examination utilized to detect unsuspected breast cancer at an early stage in asymptomatic women and includes the x-ray examination of the breast using equipment that is dedicated specifically for mammography, including the x-ray tube, filter, compression device, screens, film, and cassettes, and that has an average radiation exposure deli...

...(A) For the purpose of raising funds necessary to pay the expenses of implementing the provider screening requirements of subpart E of 42 C.F.R. Part 455 and except as provided in division (B) of this section, the department of medicaid shall collect an application fee from a medicaid provider before doing any of the following: (1) Entering into a provider agreement with a medicaid provider that seeks initial enroll...

...(A) Each medicaid provider agreement shall expire not later than five years from its effective date. If a provider agreement entered into before the effective date of this amendment does not have a time limit, the department of medicaid shall convert the agreement to a provider agreement with a time limit. (B) The medicaid director shall adopt rules under section 5164.02 of the Revised Code as necessary to impleme...