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The Legislative Service Commission staff updates the Revised Code on an ongoing basis, as it completes its act review of enacted legislation. Updates may be slower during some times of the year, depending on the volume of enacted legislation.

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Section 5162.06 | Components requiring federal approval or funding.

...(A) Notwithstanding any other state statute except for section 5164.061 of the Revised Code, no component, or aspect of a component, of the medicaid program shall be implemented without all of the following: (1) Subject to division (B) of this section, if the component, or aspect of the component, requires federal approval, receipt of the federal approval; (2) Sufficient federal financial participation for the co...

Section 5162.07 | Federal approval for permissive components not required.

...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...

Section 5162.10 | Review of medicaid program; corrective action; sanctions.

...The medicaid director may conduct reviews of the medicaid program. The reviews may include physical inspections of records and sites where medicaid services are provided and interviews of medicaid providers and medicaid recipients. If the director determines pursuant to a review that a person or government entity has violated a rule governing the medicaid program, the director may establish a corrective action ...

Section 5162.11 | Contract for data collection and warehouse functions assessment.

...(A) The department of medicaid shall enter into an agreement with the department of administrative services for the department of administrative services to contract through competitive selection pursuant to section 125.07 of the Revised Code with a vendor to perform an assessment of the data collection and data warehouse functions of the medicaid data warehouse system, including the ability to link the data sets of ...

Section 5162.12 | Contracts for the management of Medicaid data requests.

...(A) The medicaid director shall enter into a contract with one or more persons to receive and process, on the director's behalf, requests for medicaid recipient or claims payment data, data from reports of audits conducted under section 5165.109 of the Revised Code, or extracts or analyses of any of the foregoing data made by persons who intend to use the items prepared pursuant to the requests for commercial or acad...

Section 5162.13 | Annual report.

... shall make the report available to the public. (C) The department shall provide to the joint medicaid oversight committee a copy of the data used to calculate the information required in the report under division (A)(16) of this section.

Section 5162.132 | Annual report outlining efforts to minimize fraud, waste, and abuse.

...ort also shall be made available to the public on request.

Section 5162.133 | Annual program report; distribution; contents.

...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, general assembly, and joint medicaid oversight committee. 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 pa...

Section 5162.134 | Annual report of integrated care delivery system evaluation.

... shall make the report available to the public.

Section 5162.135 | Infant mortality scorecard.

...(A) As used in this section, "stillbirth" has the same meaning as in section 5180.12 of the Revised Code. (B) The department of medicaid shall create an infant mortality scorecard. The scorecard shall report all of the following: (1) The performance of the fee-for-service component of medicaid and each medicaid managed care organization on population health measures, including the infant mortality rate, preterm...

Section 5162.136 | Review of barriers to interventions intended to reduce tobacco use, prevent prematurity, and promote optimal birth spacing.

...(A) The department of medicaid shall conduct periodic reviews to determine the barriers that medicaid recipients face in gaining full access to interventions intended to reduce tobacco use, prevent prematurity, and promote optimal birth spacing. The first review shall occur not later than sixty days after the effective date of this section. Thereafter, reviews shall be conducted every six months. The department shal...

Section 5162.137 | Cost savings study.

...Annually, the department of medicaid shall conduct a cost savings study of the medicaid program and prepare a report based on that study recommending measures to reduce costs under that program. The department shall submit its report to the governor.

Section 5162.1310 | Evaluation of success of expansion eligibility group.

...(A) The department of medicaid shall periodically evaluate the success that members of the expansion eligibility group have with the following: (1) Obtaining employer-sponsored health insurance coverage; (2) Improving health conditions that would otherwise prevent or inhibit stable employment; (3) Improving the conditions of their employment, including duration and hours of employment. (B) For the purpose of ...

Section 5162.15 | Information required where annual medicaid payments exceed $5 million.

...(A) As used in this section; "Agent" and "contractor" include any agent, contractor, subcontractor, or other person who, on behalf of an entity, furnishes or authorizes the furnishing of medicaid services, performs billing or coding functions, or is involved in monitoring of health care that an entity provides. "Employee" includes any officer or employee (including management employees) of an entity. "Entity...

Section 5162.16 | Reporting fraud, waste, or abuse.

...A government entity that administers one or more components of the medicaid program and has reasonable cause to believe that an instance of fraud, waste, or abuse has occurred in the medicaid program shall inform the department of medicaid. The department shall collect the information in the medicaid data warehouse system established under section 5162.11 of the Revised Code.

Section 5162.20 | Cost-sharing requirements.

...(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...

Section 5162.21 | Medicaid estate recovery program.

...(A) As used in this section and section 5162.211 of the Revised Code: (1) "Estate" includes both of the following: (a) All real and personal property and other assets to be administered under Title XXI of the Revised Code and property that would be administered under that title if not for section 2113.03 or 2113.031 of the Revised Code; (b) Any other real and personal property and other assets in which an in...

Section 5162.211 | Lien against property of recipient or spouse as part of estate recovery program.

...ned by the department, administration, attorney fees, administrator fees, a sum for the payment of the costs of burial, which shall be computed by deducting from five hundred dollars whatever amount is available for the same purpose from all other sources, and a similar sum for the spouse of the decedent. (E) A lien imposed with respect to a medicaid recipient under this section shall dissolve on the recipient...

Section 5162.212 | Certification of amounts due under estate recovery program; collection.

...tion 5162.21 of the Revised Code to the attorney general pursuant to section 131.02 of the Revised Code. The attorney general may enter into a contract with any person or government entity to collect the amounts due on behalf of the attorney general. The attorney general, in entering into a contract under this section, shall comply with all of the requirements that must be met for the state to receive federal...

Section 5162.22 | Transfer of personal needs allowance account.

...(A) As used in this section: (1) "Commissioner" means a person appointed by a probate court under division (E) of section 2113.03 of the Revised Code to act as a commissioner. (2) "Home" has the same meaning as in section 3721.10 of the Revised Code. (3) "Personal needs allowance account" means an account or petty cash fund that holds the money of a resident of a residential facility or home and that the fac...

Section 5162.23 | Recovering benefits incorrectly paid.

...(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...

Section 5162.24 | Recovering health care costs provided to child.

...(A) As used in this section, "third party" has the same meaning as in section 5160.35 of the Revised Code. (B) In addition to the authority granted under section 5160.38 of the Revised Code, the department of medicaid may, to the extent necessary to reimburse its costs, garnish the wages, salary, or other employment income of, and withhold amounts from state tax refunds to, any person to whom both of the follo...

Section 5162.30 | Medicaid administrative claiming program.

...(A) The medicaid director shall create a medicaid administrative claiming program under which federal financial participation is received for the administrative costs incurred by the department of health and the Arthur G. James cancer hospital and Richard J. Solove research institute of the Ohio state university in analyzing and evaluating both of the following pursuant to sections 3701.261 and 3701.262 of the ...

Section 5162.31 | Local funds expended for administration of the healthy start component.

...Local funds, whether from public or private sources, expended by a county department of job and family services for administration of the healthy start component shall be considered to have been expended by the state for the purpose of determining the extent to which the state has complied with any federal requirement that the state provide funds to match federal financial participation for the medicaid program...

Section 5162.32 | Contracts with political subdivisions to pay nonfederal share.

...The department of medicaid may enter into contracts with political subdivisions to use funds of the political subdivision to pay the nonfederal share of expenditures under the medicaid program. The determination and provision of federal financial participation to a subdivision entering into a contract under this section shall be determined by the department, subject to section 5162.40 of the Revised Code.