Ohio Revised Code Search

...t 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 their social security numbers. The form shall include a statement, which must be signed by the applicant, indicating that she d...

...l be adopted in accordance with Chapter 119. of the Revised Code. (B) The rules shall establish all of the following: (1) The amount, duration, and scope of the medicaid services covered by the medicaid program; (2) The medicaid payment rate for each medicaid service or, in lieu of the rate, the method by which the rate is to be determined for each medicaid service; (3) Procedures for enforcing the rules adopted ...

...hich either of the following applies: (1) State statutes expressly permit the medicaid program to cover the optional service; (2) State statutes do not address whether the medicaid program may cover the optional service. (D) The medicaid program shall not cover any optional services that state statutes prohibit the medicaid program from covering.

... under the following circumstances: (1) The medicaid provider responsible for the procedure uses digital technology that meets both of the following criteria: (a) The technology is used only to collect medical and other data from a patient and electronically transmit that data securely to a health care provider in a different location for that provider's examination of the data; (b) The technology has been a...

... has the same meaning as in section 4731.65 of the Revised Code. (B) The department of medicaid shall establish a process by which a physician assistant may enter into a provider agreement. (C)(1) Subject to division (C)(2) of this section, a claim for medicaid payment for a medicaid service provided by a physician assistant to a medicaid recipient may be submitted by the physician assistant who provided the ...

...er before doing any of the following: (1) Entering into a provider agreement with a medicaid provider that seeks initial enrollment as a provider; (2) Entering into a provider agreement with a former medicaid provider that seeks re-enrollment as a provider; (3) Revalidating a medicaid provider's continued enrollment as a provider. (B) The department is not to collect an application fee from a medicaid provider th...

...ector shall adopt rules under section 5164.02 of the Revised Code as necessary to implement this section. The rules shall be consistent with subpart E of 42 C.F.R. Part 455 and include a process for revalidating medicaid providers' continued enrollments as providers. All of the following apply to the revalidation process: (1) The department shall refuse to revalidate a provider's provider agreement when the pr...

...vices, as required by the contract: (1) Design and operate medicaid management information systems, including the provision of data processing services; (2) Determine the amounts of payments to be made upon claims for medicaid; (3) Prepare and furnish to the department lists and computer tapes of such claims for payment; (4) In addition to audits which may be conducted by the department and by the auditor o...

...e department of medicaid under section 5162.35 of the Revised Code identifies that a medicaid overpayment has been made to a medicaid provider, the state agency may commence actions to recover the overpayment on behalf of the department. (B) In recovering an overpayment pursuant to this section, a state agency shall comply with the following procedures: (1) The state agency shall attempt to recover the overpay...

...(A) In rules adopted under section 5164.02 of the Revised Code, the medicaid director shall modify the manner or establish a new manner in which the following are paid under medicaid: (1) Community mental health service providers or facilities for providing community mental health services covered by the medicaid program pursuant to section 5164.15 of the Revised Code; (2) Providers of alcohol and drug addict...

...cipients eligible for the services: (1) Initial care for normal newborns; (2) Subsequent day, hospital care for normal newborns; (3) Same day, initial history and physical examination and discharge for normal newborns; (4) Initial neonatal critical care for children not more than twenty-eight days old; (5) Subsequent day, neonatal critical care for children not more than twenty-eight days old; (6) S...

...ble Care Act," section 2702, 42 U.S.C. 1396b-1.

...rganization as defined in section 4765.01 of the Revised Code. (B)(1) The medicaid director shall submit a medicaid state plan amendment to the United States centers for medicare and medicaid services seeking authorization to establish and administer a supplemental payment program to provide supplemental medicaid payments to eligible ground emergency medical transportation service providers. If approved, the medic...

...(A) Except as provided in section 5165.072 of the Revised Code, the department of medicaid shall enter into a provider agreement with a nursing facility operator who applies, and is eligible, for the provider agreement. (B) A provider agreement shall require the department to make medicaid payments to the provider in accordance with this chapter for nursing facility services the nursing facility provides to it...

...cept as otherwise provided by sections 5165.151 to 5165.158 and 5165.34 of the Revised Code, the total per medicaid day payment rate that the department of medicaid shall pay a nursing facility provider for nursing facility services the provider's nursing facility provides during a state fiscal year shall be determined as follows: (A) Determine the sum of all of the following: (1) The per medicaid day payment r...

...the director of health on or after July 1, 2005, amortization of the cost of acquiring operating rights for the relocated beds is not an allowable cost for the purpose of determining the nursing facility's medicaid payment rate.

...re than the greater of the following: (1) One thousand dollars per audit; (2) Twenty-five per cent of the cumulative amount by which the costs for which documentation was not furnished increased the total medicaid payments to the provider during the state fiscal year for which the costs were used to determine a rate. (B) If an exiting operator or owner fails to provide notice of a facility closure or voluntary wit...

...ntinues to participate in medicaid: (1) Any amount the provider is required to refund, and any interest charged, under section 5165.41 of the Revised Code; (2) The amount of any penalty imposed on the provider under section 5165.42 of the Revised Code. (B) The department and a nursing facility provider may enter into an agreement under which a deduction required by division (A) of this section is taken in in...

...ering operator that goes into effect at 12:01 a.m. on the effective date of the change of operator if all of the following requirements are met: (A) The department receives a properly completed written notice required by section 5165.51 of the Revised Code on or before the date required by that section. (B) The department receives from the department of health notice of intent to grant a change of operator licen...

...eipt of a written notice under section 5165.50 of the Revised Code of a facility closure or voluntary withdrawal of participation, on receipt of a written notice under section 5165.51 of the Revised Code of a change of operator, or on the effective date of an involuntary termination, the department of medicaid shall estimate the amount of any overpayments made under the medicaid program to the exiting operator, inclu...

...vious cost report required by section 5165.10 of the Revised Code and ends on the last day the exiting operator's provider agreement is in effect or, in the case of a voluntary withdrawal of participation, the effective date of the voluntary withdrawal of participation. The cost report shall include, as applicable, all of the following: (1) The sale price of the nursing facility; (2) A final depreciation sche...

...(A) All amounts withheld under section 5165.521 of the Revised Code from payment due an exiting operator under the medicaid program shall be deposited into the medicaid payment withholding fund created by the controlling board pursuant to section 131.35 of the Revised Code. Money in the fund shall be used as follows: (1) To pay an exiting operator when a withholding is released to the exiting operator under sectio...

...cility that is conducted under section 5165.64 of the Revised Code, including any statement of deficiencies and all findings and deficiencies cited in the statement on the basis of the survey, shall be used solely to determine the nursing facility's compliance with certification requirements or with this chapter or another chapter of the Revised Code. Those results of a survey, that statement of deficiencies, and the...

...d pursuant to division (E) of section 5165.66 of the Revised Code. The statement shall indicate the severity and scope level of each finding and fully describe the incidents or other facts that form the basis of the department's determination of the existence of each finding and deficiency. A failure by the survey team to completely disclose in the exit interview every finding that may result from the survey d...

...acting agency may, subject to sections 5165.82 and 5165.83 of the Revised Code, impose one or more of the following remedies: (A) Do either of the following: (1) Issue an order denying medicaid payments to the facility for all medicaid eligible residents admitted after the effective date of the order; (2) Impose a fine. (B) Issue an order denying medicaid payments to the facility for medicaid eligible resid...