Ohio Revised Code Search

...To the extent permissible under federal law, the department of medicaid shall redetermine the eligibility of members of the expansion eligibility group for medicaid benefits every six months.

...If a medicaid recipient is the beneficiary of a trust created pursuant to section 5815.28 of the Revised Code, then, notwithstanding any contrary provision of this chapter or of a rule adopted under section 5163.02 of the Revised Code, divisions (C) and (D) of that section shall apply in determining the assets or resources of the recipient, the recipient's estate, the settlor, or the settlor's estate and to cla...

...d supplant or replace medicaid or other public assistance; (b) A provision that prohibits the trustee from making payments that would impact or have an effect on the applicant's or recipient's right, ability, or opportunity to receive medicaid or other public assistance; (c) A provision that attempts to prevent the trust or its corpus or principal from being a resource available to the applicant or recipient. (...

...(A) The general assembly hereby finds that the state has an insurable interest in medicaid recipients because of the state's statutory right to recover from the estate of a recipient state funds used to provide the recipient with medicaid services. (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...

... Documentation may include tax returns, records from financial institutions, and real property records.

...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 5163.02 of the Revised Code. (3) The individual's sibling if the sibling has a verified equity interest in the real property and resided in the real property for at least one year immediately before the date...

...s of age or, under the "Social Security Act," section 1614, 42 U.S.C. 1382c, considered blind or disabled. (2) The individual qualifies, pursuant to the process established under division (C) of this section, for a waiver of this section due to a demonstrated hardship. (C) The director shall establish a process by which individuals may obtain a waiver of this section due to a demonstrated hardship. The process...

...in accordance with the "Social Security Act," section 1902(q), 42 U.S.C. 1396a(q). (B) In the case of a resident of a nursing facility, the monthly personal needs allowance shall be not less than fifty dollars for an individual resident and not less than one hundred dollars for a married couple if both spouses are residents of a nursing facility and their incomes are considered available to each other in determining...

...of this section to implement corrective action. Corrective action may include but is not limited to any one or more of the following: (a) Establishing formal referral and outreach methods with local health departments and local entities receiving funding through the bureau of maternal and child health; (b) Designating a specialized intake unit within the county department for healthy start applicants; (c) Est...

...(A)(1) As used in this section, subject to division (A)(2) of this section, "state or local correctional facility" means any of the following: (a) A "state correctional institution," as defined in section 2967.01 of the Revised Code; (b) A "local correctional facility," as defined in section 2903.13 of the Revised Code; (c) A correctional facility that is privately operated and managed pursuant to section 9....

...9) Asset verification; (10) Any other records or systems the department considers appropriate in order to strengthen program integrity, reduce costs, and reduce fraud, waste, and abuse in the medicaid program. (B) As part of the considerations under division (A) of this section, the department shall consider augmenting existing vendor arrangements relating to processing and managing medicaid eligibility cases. ...

...same meaning as in the "Social Security Act," section 1905(r), 42 U.S.C. 1396d(r). (F) "Federal financial participation" has the same meaning as in section 5160.01 of the Revised Code. (G) "Federal poverty line" has the same meaning as in section 5162.01 of the Revised Code. (H) "Healthcheck" means the component of the medicaid program that provides early and periodic screening, diagnostic, and treatment servic...

...ns, including procedures for corrective action plans for, and imposing financial and administrative sanctions on, persons and government entities that violate the rules. (C) The rules may be different for different medicaid services. (D) The medicaid director is not required to adopt a rule establishing the medicaid payment rate for a medicaid service if the director adopts a rule establishing the method by which t...

...(A) The medicaid program shall cover all mandatory services. (B) The medicaid program shall cover all of the optional services that state statutes require the medicaid program to cover. (C) The medicaid program may cover any of the optional services to which either of the following applies: (1) State statutes expressly permit the medicaid program to cover the optional service; (2) State statutes do not addr...

...The medicaid program shall cover occupational therapy services provided by an occupational therapist licensed under section 4755.08 of the Revised Code. Coverage shall not be limited to services provided in a hospital or nursing facility. Any licensed occupational therapist may enter into a provider agreement with the department of medicaid to provide occupational therapy services under the medicaid program.

... authorization requirement" means any practice in which coverage of a health care service, device, or drug is dependent upon a recipient or health care practitioner obtaining approval from the medicaid program prior to the service, device, or drug being performed, received, or prescribed, as applicable. (B)(1) The medicaid program shall cover evaluation and management services provided by a chiropractor if the chir...

...ollow-up care directed by an advanced practice registered nurse. Services covered as follow-up care shall include physical assessment of the mother and newborn, parent education, assistance and training in breast or bottle feeding, assessment of the home support system, performance of any medically necessary and appropriate clinical tests, and any other services that are consistent with the follow-up care recommended...

...(A) As used in this section, "doula" has the same meaning as in section 4723.89 of the Revised Code. (B) The medicaid program shall cover doula services that are provided by a doula if the doula has a valid provider agreement and is certified under section 4723.89 of the Revised Code. Medicaid payments for doula services shall be determined on the basis of each pregnancy, regardless of whether multiple births occur...

... Chapter 4731. of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery; (2) An advanced practice registered nurse who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as an advanced practice registered nurse and is designated as a clinical specialist, certified nurse-midwife, or certified nurse practitioner; (3...

...(A) As used in this section: (1) "Screening mammography" means a radiologic examination utilized to detect unsuspected breast cancer at an early stage in asymptomatic women and includes the x-ray examination of the breast using equipment that is dedicated specifically for mammography, including the x-ray tube, filter, compression device, screens, film, and cassettes, and that has an average radiation exposure deli...

...(A) Except as provided in division (C) of this section, the medicaid program shall cover prescribed, orally administered cancer medications on at least the same basis that it covers intraveneously administered or injected cancer medications. In implementing this section, the department of medicaid shall not institute cost-sharing requirements under section 5162.20 of the Revised Code for prescribed, orally admi...

...m and presented in the document titled "Ohio Guidelines for Prescribing Opioids for the Treatment of Chronic, Non-terminal Pain 80 mg of a Morphine Equivalent Daily Dose (MED) 'Trigger Point'" or a successor document, unless the guidelines are no longer in effect at the time the opioid analgesic is prescribed. (C) If the department measures the efficiency, quality of care, or clinical performance of a prescriber, in...

... rate, maternal heart rate, and uterine activity. (C) The department shall adopt rules as necessary to implement this section.

...r inborn error of metabolism; (d) Refractory or severe hypoglycemia or hyperglycemia; (e) Abnormal response to therapy related to an underlying medical condition affecting vital organs or bodily systems; (f) Severe muscle weakness, rigidity, or spasticity; (g) A high-risk stratification for a brief, resolved, unexplained, and recurrent event that is any of the following: (i) An event without respiratory inf...

...States public health service clinical practice guidelines on treating tobacco use and dependence; (b) Services associated with more than two attempts to quit using tobacco within a twelve-month period. (C) The director of health shall adopt rules in accordance with Chapter 119. of the Revised Code that establish standards and procedures for approving the forms of tobacco cessation medications and services that m...