Ohio Revised Code Search

...l be determined as follows: (A) Subtract one hundred fifty per cent of the federal poverty line, as applicable for a family size equal to the size of the individual's family, from the amount of the income of the individual's family; (B) Subtract an amount specified in rules authorized by section 5163.098 of the Revised Code from the difference determined under division (A) of this section; (C) Multiply the ...

...No individual shall be denied eligibility for the medicaid buy-in for workers with disabilities program on the basis that the individual receives services under a home and community-based services medicaid waiver component.

...An individual participating in the medicaid buy-in for workers with disabilities program may continue to participate in the program for up to six months even though the individual ceases to have earnings from employment or to be an employed individual with a medically improved disability due to ceasing to be employed if the individual continues to meet all other eligibility requirements for the program.

...If the United States secretary of health and human services requires that a provision of the medicaid buy-in for workers with disabilities program be changed or removed in order for the secretary to approve the program or to avoid an extended delay in the secretary's approval, the medicaid director shall make the change or removal. The change or removal may cause the medicaid buy-in for workers with disabilitie...

...ised Code, specify an amount to be subtracted from the difference determined under division (A) of that section. (B) The director may adopt rules under section 5163.02 of the Revised Code to specify amounts to be disregarded from an individual's earned income, unearned income, or both under division (C) of section 5163.093 of the Revised Code for the purpose of determining whether the individual is within the i...

...er section 1920 of the "Social Security Act," 42 U.S.C. 1396r-1, to make ambulatory prenatal care available to pregnant women under the medicaid program during presumptive eligibility periods. ( 2) "Qualified provider" has the same meaning as in section 1920(b)(2) of the "Social Security Act," 42 U.S.C. 1396r-1(b)(2). (B) The medicaid director shall implement the presumptive eligibility for pregnant women option. ...

...n 1905(l)(2)(B) of the "Social Security Act," 42 U.S.C. 1396d(l)(2)(B). (3) "Federally qualified health center look-alike" has the same meaning as in section 3701.047 of the Revised Code. (4) "Presumptive eligibility for children option" means the option available under section 1920A of the "Social Security Act," 42 U.S.C. 1396r-1a, to make medical assistance with respect to health care items and services availab...

...he department for approval a corrective action plan specifying the steps the qualified entity or qualified provider will take to reduce its presumptive eligibility error rate, including details about the training required under division (B)(2) of this section; (2) Provide training for all of its staff who make presumptive eligibility determinations to ensure their thorough knowledge of presumptive eligibility pres...

...As used in this section, "presumptive eligibility error rate" has the same meaning as in section 5163.103 of the Revised Code. Quarterly, the department of medicaid shall report to the general assembly the presumptive eligibility error rate for presumptive eligibility determinations made during the previous quarter. Reports made under this section shall be submitted to the general assembly in accordance with sectio...

...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. (4) ...

...(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...