Ohio Revised Code Search

...e used only to pay for the following: (1) If the former participant has purchased a health insurance policy, the former participant's costs in purchasing the policy and paying for the former participant's out-of-pocket expenses under the policy for health care services and prescription drugs covered by the policy; (2) If the former participant has obtained health care coverage under an eligible employer-sponsored h...

...rector shall adopt rules under section 5166.02 of the Revised Code to do all of the following: (A) For the purpose of division (F)(1)(a) of section 5166.402 of the Revised Code, establish requirements regarding preventative health services for healthy Ohio program participants. The requirements may differ for participants of different ages and genders. (B) For the purpose of division (G)(2) of section 5166.402 of t...

...o which all of the following apply: (1) The drug is an antidepressant or antipsychotic. (2) The drug is administered or dispensed in a standard tablet or capsule form, except that in the case of an antipsychotic, the drug also may be administered or dispensed in a long-acting injectable form. (3) The drug is prescribed by any of the following: (a) A physician who has registered the physician's psychiatric...

...ain any of the following provisions: (1) A payment rate for a prescribed drug that is less than the national average drug acquisition cost rate for that drug as determined by the United States centers for medicare and medicaid services, measured at the time the drug is administered or dispensed, or, if no such rate is available at that time, a reimbursement rate that is less than the wholesale acquisition cost of t...

... emergency services on or after January 1, 2007, from a provider that is not under contract with the organization, the provider shall accept from the organization, as payment in full, not more than the amounts (less any payments for indirect costs of medical education and direct costs of graduate medical education) that the provider could collect if the enrollee received medicaid other than through enrollment in a me...

...(A)(1) Medicaid managed care organizations shall use the state pharmacy benefit manager selected under section 5167.24 of the Revised Code pursuant to the terms of the master contract entered into under that section. All payment arrangements between the department of medicaid, medicaid managed care organizations, and the state pharmacy benefit manager shall comply with state and federal statutes, regulations adopte...

...m the immediately preceding quarter: (1) The prices that the state pharmacy benefit manager negotiated for prescribed drugs under the care management system. The price must include any rebates the state pharmacy benefit manager received from the drug manufacturer; (2) The prices the state pharmacy benefit manager paid to pharmacies for prescribed drugs; (3) Any rebate amounts the state pharmacy benefit manager ...

...(A)(1) The department of medicaid shall establish a managed care performance payment program. Under the program, the department may provide payments to medicaid managed care organizations that meet performance standards established by the department. (2) In establishing performance standards, the department may consult any of the following: (a) Any quality measurements developed under the pediatric quality measures...

...Not later than July 1, 2016, the department of medicaid shall implement strategies to improve the integrity of the care management system, including strategies to do both of the following: (A) Increase the department's oversight of medicaid managed care organizations; (B) Provide incentives for identifying fraud, waste, and abuse in the care management system.

...ctor shall do both of the following: (1) Implement and enforce division (B) of section 3902.36 of the Revised Code with respect to medicaid managed care organizations; (2) Enforce, monitor compliance with, and ensure continued compliance with this section. (C) The director may adopt rules under section 5167.02 of the Revised Code as necessary to carry out the provisions of this section.

...rector shall adopt rules under section 5168.02 of the Revised Code establishing a methodology to pay hospitals that is sufficient to expend all money in the indigent care pool. Under the rules: (A) The department of medicaid may classify similar hospitals into groups and allocate funds for distribution within each group. (B) The department shall establish a method of allocating funds to hospitals, taking into consi...

... adopt rules in accordance with Chapter 119. of the Revised Code as necessary to implement sections 5168.20 to 5168.28 of the Revised Code, including rules that specify the percentage of hospitals' total facility costs to be used in calculating hospitals' assessments under section 5168.21 of the Revised Code. (B) The rules adopted under this section may do the following: (1) Provide that a hospital's total faci...

...) Not later than four months after July 17, 2009, the department of medicaid shall apply to the United States secretary of health and human services for a waiver under the "Social Security Act," section 1903(w)(3)(E), 42 U.S.C. 1396b(w)(3)(E), as necessary to do both of the following regarding the franchise permit fee assessed under section 5168.42 of the Revised Code: (1) Reduce the franchise permit fee rate...

...nder divisions (A) and (B) of section 5168.42 of the Revised Code and not later than the first day of each June, report to the department of medicaid the following: (1) For each nursing home, the number of beds in the nursing home licensed on the preceding first day of May under section 3721.02 or 3721.09 of the Revised Code or certified on that date under Title XVIII or Title XIX; (2) For each hospital, the ...

...sessing a penalty pursuant to section 5168.51 of the Revised Code, the department of medicaid may do any of the following if a nursing facility or hospital fails to pay the full amount of a franchise permit fee installment when due: (1) Withhold an amount less than or equal to the installment and penalty assessed under section 5168.51 of the Revised Code from a medicaid payment due the nursing facility or hos...

...all be the product of the following: (1) The ICF/IID's medicaid-certified capacity; (2) The number of days in the month.

...sessing a penalty pursuant to section 5168.65 of the Revised Code, the department of developmental disabilities may do any of the following if an ICF/IID fails to pay the full amount of a franchise permit fee installment when due: (1) Withhold an amount less than or equal to the installment and penalty assessed under section 5168.65 of the Revised Code from a medicaid payment due the ICF/IID until the ICF/IID...

... For the purposes specified in section 5168.85 of the Revised Code and subject to sections 5168.82, 5168.83, and 5168.84 of the Revised Code, a franchise fee is hereby imposed each month beginning with July 2017 on each health insuring corporation plan. The franchise fee shall have a component based on Ohio medicaid member months and another component based on other Ohio member months. (B) The department of medicai...

...) As used in this section and section 517.072 of the Revised Code, "fetal death" has the same meaning as in section 3705.01 of the Revised Code. (B) A board of township trustees may adopt rules for any township cemetery over which it has control for the burial, re-interment, or disinterment of the product of a fetal death. (C) With regard to the product of a fetal death, on the request of the mother and in ...

...n all respects as required by sections 517.01 to 517.32, inclusive, of the Revised Code. (B) A board of township trustees is not required to accept and take possession of the grounds of a public cemetery, or to take care of, keep in repair, hold, treat, or manage the grounds as described in division (A) of this section, if, as a result of the conveyance, any parcel abutting the cemetery grounds or from which the gr...

...ms focused on any of the following: (1) Adoption, child welfare, and foster care services; (2) Early identification and intervention regarding behavioral health, including, but not limited to, early intervention services, early childhood mental health initiatives, multi-system youth services, and family support services administered through the Ohio family and children first cabinet council, Ohio commission on ...

...esidential camp, as defined in section 2151.011 of the Revised Code, a child day camp, as defined in section 5104.01 of the Revised Code, or a child day camp operated by any county, township, municipal corporation, township park district created under section 511.18 of the Revised Code, park district created under section 1545.04 of the Revised Code, or joint recreation district established under section 755.14 of th...

...tablished and maintained under section 5180.40 of the Revised Code may be accessed or entered only as follows: (1) The department of job and family services, the department of children and youth, a public children services agency, a title IV-E agency, a prosecuting attorney, a private child placing agency, and a private noncustodial agency may access or enter the information when either of the following is the cas...

...ormation system established in section 5180.40 of the Revised Code, the department of children and youth shall adopt rules in accordance with Chapter 119. of the Revised Code regarding a private child placing agency's or private noncustodial agency's access, data entry, and use of information in the uniform statewide automated child welfare information system. (B)(1) The department of children and youth may adopt ...

...try on child abuse and neglect by March 1, 2024.