Ohio Revised Code Search
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Section 5162.35 | Contracts for administration of components.
...The department of medicaid may enter into contracts with one or more other state agencies or political subdivisions to have the state agency or political subdivision administer one or more components of the medicaid program, or one or more aspects of a component, under the department's supervision. A state agency or political subdivision that enters into such a contract shall comply with the terms of the contra... |
Section 5162.36 | Medicaid school component.
...The medicaid director shall create, in accordance with sections 5162.36 to 5 162.366 of the Revised Code, the medicaid school component of the medicaid program. |
Section 5162.361 | Claim by qualified medicaid school provider.
...A qualified medicaid school provider participating in the medicaid school component of the medicaid program may submit a claim to the department of medicaid for federal financial participation for providing, in schools, services covered by the medicaid school component to medicaid recipients who are eligible for the services. No qualified medicaid school provider may submit such a claim before the provider incurs the... |
Section 5162.362 | Federal financial participation for medicaid school claims.
...The department of medicaid shall seek federal financial participation for each claim a qualified medicaid school provider properly submits to the department under section 5162.361 of the Revised Code. The department shall disburse the federal financial participation the department receives from the federal government for such a claim to the qualified medicaid school provider that submitted the claim. The depart... |
Section 5162.363 | Administration of medicaid school component.
...The department of medicaid shall enter into an interagency agreement with the department of education and workforce under section 5162.35 of the Revised Code that provides for the department of education and workforce to administer the medicaid school component of the medicaid program other than the aspects of the component that sections 5162.36 to 5162.366 of the Revised Code require the department of medicaid to ad... |
Section 5162.364 | Adoption of rules for medicaid school component.
...The medicaid director shall adopt rules under section 5162.02 of the Revised Code as necessary to implement the medicaid school component of the medicaid program, including rules that establish or specify all of the following: (A) Conditions a board of education of a city, local, or exempted school district, a governing board of an educational service center, governing authority of a community school established u... |
Section 5162.365 | Responsibility for repaying overpayments.
...(A) A qualified medicaid school provider is solely responsible for timely repaying any overpayment that the provider receives under the medicaid school component of the medicaid program and that is discovered by a federal or state audit. This is the case regardless of whether the audit's finding identifies the provider, department of medicaid, or department of education and workforce as being responsible for the over... |
Section 5162.366 | Referrals for certain services under the Medicaid School Program.
...(A) Subject to division (B) of this section and for the purpose of a medicaid recipient receiving, in accordance with the recipient's individualized education program, physical therapy services, occupational therapy services, speech-language pathology services, or audiology services under the medicaid school component of the medicaid program: (1) A physical therapist is a licensed practitioner of the healing arts fo... |
Section 5162.37 | Contract approval required.
...Any contract the department of medicaid enters into with the department of mental health and addiction services under section 5162.35 of the Revised Code is subject to the approval of the director of budget and management and shall require or specify all of the following: (A) That section 5162.371 of the Revised Code be complied with; (B) How providers will be paid for providing the services; (C) The respons... |
Section 5162.371 | Contracts with department of mental health and addiction services; payment of nonfederal share of medicaid payment.
...If the department of medicaid enters into a contract with the department of mental health and addiction services under section 5162.35 of the Revised Code, the department of medicaid shall pay the nonfederal share of any medicaid payment to a provider for services under the component, or aspect of the component, the department of mental health and addiction services administers. |
Section 5162.40 | Retaining or collecting percentage of federal financial participation.
...(A) If a state agency or political subdivision administers one or more components of the medicaid program or administers one or more aspects of such a component, the department of medicaid may retain or collect not more than ten per cent of the federal financial participation the state agency or political subdivision obtains through an approved, administrative claim regarding the component or aspect of the component.... |
Section 5162.41 | Retaining or collecting percentage of supplemental payment.
...The department of medicaid may retain or collect a percentage of the federal financial participation included in a supplemental medicaid payment to one or more medicaid providers owned or operated by a state agency or political subdivision that brings the payment to such provider or providers to the upper payment limit established by 42 C.F.R. 447.272. If the department retains or collects a percentage of that federa... |
Section 5162.50 | Health care-federal fund.
...(A) The health care - federal fund is hereby created in the state treasury. All of the following shall be credited to the fund: (1) Funds that division (B) of section 5168.11 of the Revised Code requires be credited to the fund; (2) The federal share of all rebates paid by drug manufacturers to the department of medicaid in accordance with a rebate agreement required by the "Social Security Act," section 192... |
Section 5162.52 | Health care/medicaid support and recoveries fund.
...(A) The health care/medicaid support and recoveries fund is hereby created in the state treasury. All of the following shall be credited to the fund: (1) Except as otherwise provided by statute or as authorized by the controlling board, the nonfederal share of all medicaid-related revenues, collections, and recoveries; (2) Federal reimbursement received for payment adjustments made pursuant to section 1923 of the... |
Section 5162.56 | Health care special activities fund.
...There is created in the state treasury the health care special activities fund. The department of medicaid shall deposit all funds it receives pursuant to the administration of the medicaid program into the fund, other than any such funds that are required by law to be deposited into another fund. The department shall use the money in the fund to pay for expenses related to the services provided under, and the ... |
Section 5162.65 | Refunds and reconciliation fund.
...There is hereby created in the state treasury the refunds and reconciliation fund. Money the department of medicaid receives from a refund or reconciliation shall be deposited into the refunds and reconciliation fund if the department does not know the appropriate fund for the money at the time the department receives the money or if the money is to go to another government entity. Money transferred from the departm... |
Section 5162.66 | Residents protection fund.
...(A) There is hereby created in the state treasury the residents protection fund. All of the following shall be deposited into the fund: (1) The proceeds of all fines, including interest, collected under sections 5165.60 to 5165.89 of the Revised Code; (2) The proceeds of all fines, including interest, collected under section 173.42 of the Revised Code; (3) The portions of civil money penalties and corresponding in... |
Section 5162.70 | Reforms to medicaid program.
...(A) As used in this section: (1) "CPI" means the consumer price index for all urban consumers as published by the United States bureau of labor statistics. (2) "CPI medical inflation rate" means the inflation rate for medical care, or the successor term for medical care, for the midwest region as specified in the CPI. (3) "JMOC projected medical inflation rate" means the following: (a) The projected medic... |
Section 5162.71 | Implementation of systems to improve health and reduce health disparities.
...The medicaid director shall implement within the medicaid program systems that do both of the following: (A) Improve the health of medicaid recipients through the use of population health measures; (B) Reduce health disparities, including, but not limited to, those within racial and ethnic populations. |
Section 5162.72 | Strategies to address social determinants of health.
...The medicaid director shall implement within the medicaid program strategies that address social determinants of health, including employment, housing, transportation, food, interpersonal safety, and toxic stress. |
Section 5162.73 | Dental services for pregnant Medicaid recipients.
...(A) The Department of Medicaid may establish and administer a program to provide dental services to pregnant Medicaid recipients. If the program is established, all of the following shall apply: (1) Medicaid recipients who are members of the group described in section 5163.06 of the Revised Code shall be eligible to receive two dental cleanings per year. (2) The Department shall give priority to those Medicaid r... |
Section 5162.75 | Notification of veteran services.
...The medicaid director shall provide, to a veteran who has submitted an application for the medicaid program, information about the county veterans service office that can assist with investigating and applying for benefits through the United States department of veterans affairs. As used in this section, "veteran" has the same meaning as in section 5901.01 of the Revised Code. |
Section 5162.80 | Good faith estimates for charges and payments.
...(A) A provider of medical services licensed, accredited, or certified under Chapter 3721., 3727., 4715., 4725., 4731., 4732., 4734., 4747., 4753., 4755., 4757., or 4779. of the Revised Code shall provide in writing, before products, services, or procedures are provided, a reasonable, good-faith estimate of all of the following for the provider's non-emergency products, services, or procedures: (1) The amount the pro... |
Section 5162.82 | Payment rate increase report to JMOC.
...Before making any payment rate increases greater than ten per cent under the medicaid program, the medicaid director shall notify the joint medicaid oversight committee of the increase and be available to testify before the joint medicaid oversight committee regarding the increase. |
Section 5163.01 | Definitions.
...As used in this chapter: "Caretaker relative" has the same meaning as in 42 C.F.R. 435.4 as that regulation is amended effective January 1, 2014. "Expansion eligibility group" means the medicaid eligibility group described in section 1902(a)(10)(A)(i)(VIII) of the "Social Security Act," 42 U.S.C. 1396a(a)(10)(A)(i)(VIII). "Federal financial participation" has the same meaning as in section 5160.01 of the Revised C... |