Ohio Revised Code Search

...rogram, both of the following apply: (1) An individual may apply for the medical assistance program to the department or an agency authorized by an agreement entered into under division (B) of this section to accept the individual's application; (2) The department is subject to federal statutes and regulations and state statutes and rules that require, permit, or prohibit an action regarding accepting applica...

...party under division (B)(5) of section 5160.40 of the Revised Code on a claim for payment of a medical item or service provided to a medical assistance recipient is final on the date that is two years after the payment was made to the department of medicaid or the applicable medicaid managed care organization. After a claim is final, the claim is subject to adjustment only if an action for recovery of an overpayment ...

...(A) For the purposes of section 5160.45 of the Revised Code, an authorization shall be made on a form that uses language understandable to the average person and contains all of the following: (1) A description of the information to be used or disclosed that identifies the information in a specific and meaningful fashion; (2) The name or other specific identification of the person or class of persons authori...

...icaid shall do both of the following: (1) Enter into any necessary agreements with the United States department of health and human services and neighboring states to join and participate as an active member in the public assistance reporting information system; (2) Explore joining other multistate cooperatives, such as the national accuracy clearinghouse, to identify individuals enrolled in public assistance progr...

...ams known as tricare and champva. (B) (1) The department of medicaid shall review information in the public assistance reporting information system to determine whether an individual who is a medical assistance recipient may be eligible for federal military-related health care benefits. If the department determines that the individual may be eligible for federal military-related health care benefits, it shall notify...

... all of the following requirements: (1) Is the parent of a child who is under nineteen years of age, resides with the parent, and is enrolled in the children's health insurance program part I or II or the medicaid program; (2) Is uninsured; (3) Has a family income that does not exceed one hundred per cent of the federal poverty line. (B) A waiver request the director submits under division (A) of this secti...

...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 component or aspect of the...

...delineated by race and ethnic group: (1) The estimated number of pregnant women, infants, and children eligible for the program; (2) The actual number of eligible persons enrolled in the program; (3) The actual number of enrolled pregnant women categorized by estimated gestational age at time of enrollment; (4) The average number of days between the following events: (a) A pregnant woman's application for m...

...ility 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 aiding the department's evaluations under this section, medicaid managed care organizations shall collect a...

...ision (B) of this section and section 5162.23 of the Revised Code, no lien may be imposed against the property of an individual before the individual's death on account of medicaid services correctly paid or to be paid on the individual's behalf. (B) Except as provided in division (C) of this section, the department of medicaid may impose a lien against the real property of a medicaid recipient who is a perma...

...(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...

...ector 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 equitable interest; ...

...y" 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 following apply: (1) The person is required...

... the following pursuant to sections 3701.261 and 3701.262 of the Revised Code: (1) Cancer reports under the Ohio cancer incidence surveillance system; (2) The incidence, prevalence, costs, and medical consequences of cancer on medicaid recipients and other low-income populations. (B) The medicaid director shall consult with the director of health in creating the medicaid administrative claiming program.

...ovider is responsible for repaying: (1) Make a payment to the federal government to meet or delay the provider's repayment obligation; (2) Assume the provider's repayment obligation; (3) Forgive the provider's repayment obligation. (C) Each qualified medicaid school provider shall indemnify and hold harmless the department of medicaid for any cost or penalty resulting from a federal or state audit finding...

...wing 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 1927, 42 U.S.C. 1396r-8; (3) The federal share of all supplemental rebates paid by drug manufa...

...d, 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 recipients residing in areas of the state with high preterm birth rates. (3) The Department shall inform Medicaid recipients about the program and market the...

...credited, 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 provider will charge the patient or the consumer's...

...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 Code. "Federal poverty line" has the same meaning as in section 5162.01 of the Revised Code. "Hea...

... by the "Social Security Act," section 1931(b)(2)(C), 42 U.S.C. 1396u-1(b)(2)(C), to set the income eligibility threshold at ninety per cent of the federal poverty line for parents and caretaker relatives who are covered by the medicaid program under that section of the "Social Security Act."

...dance with rules authorized by section 5163.098 of the Revised Code qualifies for the medicaid program: (A) Applies for the medicaid buy-in for workers with disabilities program; (B) Provides satisfactory evidence of all of the following: (1) That the individual is at least sixteen years of age and under sixty-five years of age; (2) Except as provided in section 5163.096 of the Revised Code, that one of the ...

...ector shall adopt rules under section 5163.02 of the Revised Code as necessary to implement the medicaid buy-in for workers with disabilities program. The rules shall do all of the following: (1) Specify assets, asset values, and amounts to be disregarded in determining asset and income eligibility limits for the program; (2) Establish meanings for the terms "earned income," "health insurance," "resources," ...

...(A) As used in this section: (1) "Children's hospital" has the same meaning as in section 2151.86 of the Revised Code. (2) "Federally qualified health center" has the same meaning as in section 1905(l)(2)(B) of the "Social Security Act," 42 U.S.C. 1396d(l)(2)(B). (3) "Federally qualified health center look-alike" has the same meaning as in section 3701.047 of the Revised Code. (4) "Presumptive eligibility for...

...vices. (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 of the insured or maturity of the policy. (2) "Owner" means the person who has the right to designate the beneficiary of a life insurance policy and to change the designation. (C) The value of a life insurance policy that would otherwise be...

...ead or principal place of residence: (1) The individual's spouse; (2) The individual's child if any of the following apply: (a) The child is under twenty-one years of age. (b) The child is considered blind or disabled under the "Social Security Act," section 1614, 42 U.S.C. 1382c. (c) The child is financially dependent on the individual for housing as determined in accordance with rules adopted under section...