Ohio Revised Code Search

...t fails to pay the nonfederal share of medicaid expenditures that the county board is required by sections 5126.059 and 5126.0510 of the Revised Code to pay. The department may bring the mandamus action in the court of common pleas of the county served by the county board or in the Franklin county court of common pleas.

... in consultation with the department of medicaid, office of budget and management, and county boards of developmental disabilities, shall adopt rules in accordance with Chapter 119. of the Revised Code to establish both of the following in the event a county property tax levy for services for individuals with developmental disabilities fails: (A) A method of paying for home and community-based services; (B) A metho...

... civil or criminal action regarding the medicaid program or a program the department administers. (2) An applicant or employee for whom the responsible entity has obtained reports under this section may submit a written request to the responsible entity to have copies of the reports sent to any state agency, entity of local government, or private entity. The applicant or employee shall specify in the request the ag...

... civil or criminal action regarding the medicaid program. (2) An applicant for whom the director has obtained reports under this section may submit a written request to the director to have copies of the reports sent to any person or state or local government entity. The applicant shall specify in the request the person or entities to which the copies are to be sent. On receiving the request, the director shall sen...

...responsible for the nonfederal share of medicaid expenditures for the individual's care in the state-operated ICF/IID. The department of developmental disabilities shall collect the amount of the nonfederal share from the county board by either withholding that amount from funds the department has otherwise allocated to the county board or submitting an invoice for payment of that amount to the county board. (B) Div...

...The department of medicaid shall not revalidate an ICF/IID provider agreement if the provider fails to maintain eligibility for the provider agreement as provided in section 5124.06 of the Revised Code.

...ermined not to be allowable costs, the medicaid payment rate determined under this chapter as a result of the determination regarding allowable costs, and the reasons for the determination and resulting rate. The department shall allow the provider to verify the calculation and submit additional information.

...t shall not take an action that affects medicaid payment rates for prior payment periods except in accordance with sections 5124.41 and 5124.42 of the Revised Code. (C) The director of developmental disabilities shall adopt rules under section 5124.03 of the Revised Code as necessary to implement this section.

...evelopmental disabilities shall adjust medicaid payment rates determined under this chapter to account for reasonable additional costs that must be incurred by ICFs/IID to comply with requirements of federal or state statutes, rules, or policies enacted or amended after January 1, 1992, or with orders issued by state or local fire authorities.

...hows that the provider received a lower medicaid payment rate under the original cost report than the provider was entitled to receive, the department of developmental disabilities shall adjust the provider's rate for the ICF/IID prospectively to reflect the corrected information. The department shall pay the adjusted rate beginning two months after the first day of the month after the provider files the amended cost...

... was not furnished increased the total medicaid payments to the provider during the 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 termination as required by section 5124.50 of the Revised Code, or an exiting operator or owner and entering operator fail to provide notice of a change of operator as req...

...5124.109 of the Revised Code; (B) Any medicaid payment deemed an overpayment under section 5124.523 of the Revised Code; (C) Any penalty the department imposes under section 5124.42 of the Revised Code or section 5124.523 of the Revised Code.

...The department of medicaid may enter into a provider agreement with an entering 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 5124.51 of the Revised Code on or before the date required by that section. (B) The department receives both ...

...(A) The department of medicaid may enter into a provider agreement with an entering operator that goes into effect at 12:01 a.m. on the date determined under division (B) of this section if all of the following are the case: (1) The department receives a properly completed written notice required by section 5124.51 of the Revised Code. (2) The department receives, from the entering operator and in accordance ...

...vider agreement with the department of medicaid under section 5124.511 or 5124.512 of the Revised Code shall do all of the following: (A) Comply with all applicable federal statutes and regulations; (B) Comply with section 5124.07 of the Revised Code and all other applicable state statutes and rules; (C) Comply with all the terms and conditions of the exiting operator's provider agreement, including all of t...

...The department of medicaid may enter into a provider agreement as provided in section 5124.07 of the Revised Code, rather than section 5124.511 or 5124.512 of the Revised Code, with an entering operator if the entering operator does not agree to a provider agreement that satisfies the requirements of division (C) of section 5124.513 of the Revised Code. The department may not enter into the provider agreement u...

...h that section, all payments under the medicaid program for the period the cost report is required to cover are deemed overpayments until the date the department receives the properly completed cost report. The department may impose on the exiting operator a penalty of one hundred dollars for each calendar day the properly completed cost report is late.

...iting operator final payment under the medicaid program until the department receives all properly completed cost reports the exiting operator is required to file under sections 5124.10 and 5124.522 of the Revised Code.

...ntal disabilities may request that the medicaid director seek the approval of the United States secretary of health and human services to increase the number of slots available for home and community-based services by a number not exceeding the number of beds that were part of the licensed capacity of a residential facility that had its license revoked or surrendered under section 5123.19 of the Revised Code i...

... of developmental disabilities that has medicaid local administrative authority under division (A) of section 5126.055 of the Revised Code for home and community-based services and refuses to permit an individual to obtain home and community-based services from a qualified and willing provider shall provide the individual timely notice that the individual may appeal under section 5160.31 of the Revised Code. (B) Ex...

... United States centers for medicare and medicaid services. The department or designated entity shall notify the regional council or board of the date on which the audit is to begin. The department may permit a regional council or board to submit changes to the cost report before the audit begins. If the department or designated entity determines that a filed cost report is not auditable, it shall provide written no...

...ncluded in the plans are funded through medicaid; (4) Establish budgets for services based on the individual's assessed needs and preferred ways of meeting those needs; (5) Assist individuals in making selections from among the providers they have chosen; (6) Ensure that services are effectively coordinated and provided by appropriate providers; (7) Establish and implement an ongoing system of monitoring the ...

....47 of the Revised Code do not apply to medicaid-funded supported living. (B) As used in sections 5126.40 to 5126.47 of the Revised Code, "provider" means a person or government entity certified by the director of developmental disabilities to provide supported living for individuals with developmental disabilities. (C) On and after July 1, 1995, each county board of developmental disabilities shall plan and develo...

...The medicaid director shall adopt rules as necessary to implement this chapter.

...state treasury. Money the department of medicaid receives from private foundations in support of pilot projects that promote exemplary programs that enhance programs the department administers shall be credited to the fund. The department may expend the money on such projects, may use the money, to the extent allowable, to match federal financial participation in support of such projects, and shall comply with ...