Ohio Revised Code Search

...ion" has the same meaning as in section 119.01 of the Revised Code. (B) "Behavioral health redesign" means revisions to the medicaid program's coverage of community behavioral health services beginning July 1, 2017, including revisions that update medicaid billing codes and payment rates for community behavioral health services. (C) "Clean claim" has the same meaning as in 42 C.F.R. 447.45(b). (D) "Community be...

... a mother and her newborn as follows: (1) The medicaid program shall cover a minimum of forty-eight hours of inpatient care following a normal vaginal delivery and a minimum of ninety-six hours of inpatient care following a cesarean delivery. Services covered as inpatient care shall include medical, educational, and any other services that are consistent with the inpatient care recommended in the protocols and guide...

... meet all of the following criteria: (1) The patient is under one year of age. (2) The patient has a complex or acute illness of unknown etiology that is not confirmed to be caused by an environmental exposure, toxic ingestion, infection with normal response to therapy, or trauma. (3) The patient is receiving hospital services in an intensive care unit or other high acuity care unit within a hospital. (C) A l...

...(A)(1) Except as provided in division (A)(2) of this section, the department of medicaid may recover a medicaid payment or portion of a payment made to a medicaid provider to which the provider is not entitled if the department notifies the provider of the overpayment during the five-year period immediately following the end of the state fiscal year in which the overpayment was made. (2) In the case of a hospital me...

...if all of the following are the case: (1) The hospital is located in a county in which participants in the care management system are required before January 1, 2006, to be enrolled in a medicaid managed care organization that is a health insuring corporation. (2) The hospital has entered into a contract before January 1, 2006, with at least one health insuring corporation serving the participants specified in...

...pursuant to division (B)(2) of section 5164.7512 of the Revised Code: (1) The process shall be clear and convenient. (2) The process shall be easily accessible on the department's web site. (3) The process shall require that a medicaid provider initiate a step therapy exemption request on behalf of a medicaid recipient. (4) The process shall require supporting documentation and rationale be submitted with ea...

...(A) Not later than July 1, 2020, the medicaid director shall establish an annual benchmark for prescribed drug spending growth under the medicaid program. If the director determines that prescribed drug spending in a given year is projected to exceed the benchmark for that year, the director shall identify specific prescribed drugs that significantly contribute to exceeding the benchmark. (B) For a prescribed drug ...

...blished in rules adopted under section 5164.02 of the Revised Code. In accordance with section 5162.021 of the Revised Code, the medicaid director shall adopt rules authorizing the directors of other state agencies to adopt rules regarding the medicaid coverage of telehealth services under programs administered by the other state agencies. Any such rules adopted by the medicaid director or the directors of other st...

...ix peer groups composed as follows: (1) Each nursing facility located in any of the following counties shall be placed in peer group one or two: Brown, Butler, Clermont, Clinton, Hamilton, and Warren. Each nursing facility located in any of those counties that has fewer than one hundred beds shall be placed in peer group one. Each nursing facility located in any of those counties that has one hundred or more beds ...

...(A) As used in this section: (1) "Special focus facility program" means the program conducted by the United States secretary of health and human services pursuant to the "Social Security Act," section 1919(f)(10), 42 U.S.C. 1396r(f)(10). (2) "Standard health surveys" mean the comprehensive on-site inspections conducted by the department of health on behalf of the United States centers for medicare and medicaid ...

...rs on behalf of the nursing facility: (1) Medicaid payments made in accordance with the provider agreement for the nursing facility; (2) Funds from the residents protection fund that the department provides the manager under section 5162.66 of the Revised Code; (3) Other funds the department determines are appropriate if such use of the funds is consistent with the appropriations that authorize the use of the...

...(A) An order issued under section 5165.72, 5165.73, 5165.74, 5165.77, or 5165.84 of the Revised Code denying medicaid payments to a nursing facility for all medicaid eligible residents admitted after its effective date, or an order issued under section 5165.72, 5165.73, or 5165.74 of the Revised Code denying medicaid payments to a nursing facility for medicaid eligible residents admitted after the effective dat...

...e used to pay only for the following: (1) Until the amount of the noncore portion of the participant's buckeye account is zero, the costs of health care services that are covered by the health plan and provided to the participant by a provider participating in the health plan; (2) The participant's copayments under division (C) of section 5166.401 of the Revised Code; (3) Subject to rules authorized by section 516...

...(A) As used in this section: (1) "Children's care network" means any of the following: (a) A children's hospital; (b) A group of children's hospitals; (c) A group of pediatric physicians. (2) "Children's hospital" has the same meaning as in section 2151.86 of the Revised Code. (B) If the department of medicaid includes in the care management system, pursuant to section 5167.03 of the Revised Code, individua...

...(A) Except as provided in section 5162.52 of the Revised Code, all payments of assessments by hospitals under section 5168.06 of the Revised Code and all intergovernmental transfers under section 5168.07 of the Revised Code shall be deposited in the state treasury to the credit of the hospital care assurance program fund, hereby created. All investment earnings of the hospital care assurance program fund shall be cre...

...As used in sections 5168.40 to 5168.56 of the Revised Code: (A) "Bed surrender" means the following: (1) In the case of a nursing home, the removal of a bed from a nursing home's licensed capacity in a manner that reduces the total licensed capacity of all nursing homes and makes it impossible for the bed to ever be a part of any nursing home's licensed capacity; (2) In the case of a hospital, the removal of...

... following: (A) Subject to sections 5168.44, 5168.45, and 5168.48 of the Revised Code and divisions (C) and (D) of this section and for the purposes specified in section 5168.54 of the Revised Code, determine an annual franchise permit fee on each nursing home in an amount equal to the franchise permit fee rate multiplied by the product of the following: (1) The number of beds licensed as nursing home beds, ...

...he following: (A) Subject to section 5168.64 of the Revised Code and divisions (B) and (C) of this section and for the purposes specified in section 5168.69 of the Revised Code, quarterly assess each ICF/IID a franchise permit fee equal to the product of the following: (1) The franchise permit fee rate; (2) The number of the ICF/IID's inpatient days for the quarter as determined using the monthly reports submit...

...le or deed was executed before July 24, 1986, or an entombment, including a mausoleum, columbarium, or other interment right for which the terms of sale or deed was executed before September 29, 2015, if the board determines the lot or right is unused and adopts a resolution creating a procedure for right of reentry in accordance with this section. The resolution shall state that the board of township trustees has th...

...plicant for disinterment under section 517.23 of the Revised Code shall be in writing and shall state whether the applicant is the designated representative to whom the decedent has assigned the right of disposition of the decedent's body in a written declaration pursuant to section 2108.70 of the Revised Code and exercised such right at the time of the declarant's death or, if none, the surviving spouse, that the ap...

...outh shall do all of the following: (1) Publish stillbirth data compiled from the department of health's fetal death statistical file and make it available on the department of children and youth's internet web site; (2) Review the stillbirth data described in division (B)(1) of this section and identify potential trends in the incidence of stillbirth and the possible causes of, and conditions that could lead t...

... shall report all of the following: (1) The state's performance on population health measures, including the infant mortality rate, preterm birth rate, and low birth weight rate, delineated by race, ethnic group, region of the state, and the state as a whole; (2) Preliminary data the department possesses on the state's unexpected infant death rate; (3) To the extent such information is available, the state's...

...gram by doing all of the following: (1) Developing educational materials that present readily comprehendible information on safe sleeping practices for infants and possible causes of sudden unexpected infant death; (2) Making available on the department's internet web site in an easily accessible format the educational materials developed under division (B)(1) of this section; (3) Providing annual training c...

...(A) As used in this section: (1) "Dollywood foundation" means the Dollywood nonprofit foundation headquartered in Tennessee. (2) "Dolly Parton's imagination library of Ohio" means the nonprofit organization within the Dollywood foundation created to fund and manage the operations of the Dolly Parton's imagination library in the state. (B) The Dolly Parton's imagination library of Ohio advisory board is created....

...(A) As used in this section: (1) "Custodian," "guardian," and "minor child" have the same meanings as in section 5107.02 of the Revised Code. (2) "Federal poverty guidelines" has the same meaning as in section 5101.46 of the Revised Code. (3) "Kinship caregiver" has the same meaning as in section 5180.50 of the Revised Code. (B) Subject to division (E) of section 5101.801 of the Revised Code, there is her...