Ohio Revised Code Search
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Section 5168.01 | Hospital care assurance program definitions.
...arity care," "courtesy care," and "contractual allowances" have the same meanings given these terms in regulations adopted under Title XVIII of the "Social Security Act," 42 U.S.C. 1395 et seq. (B) "Cost reporting period" means the twelve-month period used by a hospital in reporting costs for purposes of Title XVIII of the "Social Security Act," 42 U.S.C. 1395 et seq. (C) "Disproportionate share hospital" means a h... |
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Section 5168.02 | Adoption of rules.
...tal included under the "Social Security Act," section 1923(b), 42 U.S.C. 1396r-4(b), and any other hospital the director determines appropriate; (2) Prescribe the form for submission of cost reports under section 5168.05 of the Revised Code; (3) Establish, in accordance with division (A) of section 5168.06 of the Revised Code, the assessment rate or rates to be applied to hospitals under that section; (4) Es... |
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Section 5168.03 | Provisions dependent on assessment as permissible health care-related tax.
...ed tax pursuant to the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w). Whenever the department of medicaid is informed that the assessment is an impermissible health care-related tax, the department shall promptly refund to each hospital the amount of money currently in the hospital care assurance program fund created by section 5168.11 of the Revised Code that has been paid by the hospital under section ... |
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Section 5168.04 | Program year basis of operation.
...The department of medicaid shall operate the hospital care assurance program established by sections 5168.01 to 5168.14 of the Revised Code on a program year basis. The department shall complete all program requirements on or before the thirtieth day of September each year. |
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Section 5168.05 | Submitting financial statement and cost report.
... separately from courtesy care and contractual allowances. (B) Except as provided in division (C) of this section, each hospital, within one hundred eighty days after the end of the hospital's cost reporting period, shall submit to the department a cost report in a format prescribed in rules adopted under section 5168.02 of the Revised Code. The department shall grant a hospital an extension of the one hundred eigh... |
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Section 5168.06 | Annual assessment.
...aid services under the "Social Security Act," section 1923(f), 42 U.S.C. 1396r-4(f). (B)(1) Except as provided in division (B)(3) of this section, each hospital shall pay its assessment in periodic installments in accordance with a schedule established in rules adopted under section 5168.02 of the Revised Code. (2) The installments shall be equal in amount, unless either of the following applies: (a) The depart... |
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Section 5168.07 | Requiring governmental hospitals to make intergovernmental transfers.
...aid services under the "Social Security Act," section 1923(f), 42 U.S.C. 1396r-4(f). (B) Before or during each program year, the department shall notify each governmental hospital of the amount of the intergovernmental transfer it is required to make during the program year. Each governmental hospital shall make intergovernmental transfers as required by the department under this section in periodic installments, e... |
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Section 5168.08 | Preliminary determination of assessment.
...t prescribed under the "Social Security Act," section 1923(f), 42 U.S.C. 1396r-4(f). When adjusted, the assessment rate or rates must comply with division (A) of section 5168.06 of the Revised Code. An adjusted intergovernmental transfer must comply with division (A) of section 5168.07 of the Revised Code. The department shall notify hospitals of adjustments made under this division and adjust for the remainder of th... |
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Section 5168.09 | Methodology to pay hospitals sufficient to expend all money in indigent care pool.
...ents of Title V of the "Social Security Act," 42 U.S.C. 701 et seq.; (3) The amount of uncompensated care provided by the hospital or group of hospitals; (4) Other factors that the director considers to be appropriate indicators of indigent care. (C) The department shall distribute funds to each hospital or group of hospitals in a manner that first may provide for an additional distribution to individual hospitals... |
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Section 5168.10 | Prohibiting replacing funds appropriated for medicaid program.
...Except for moneys deposited into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code, the department of medicaid shall not use money paid to the department under sections 5168.06 and 5168.07 of the Revised Code or money that the department pays to hospitals under section 5168.09 of the Revised Code to replace any funds appropriated by the general assembly for the med... |
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Section 5168.11 | Hospital care assurance program fund.
...nts it should have received; (2) Take action to recover from a hospital any amounts that the audit reveals it should have been required to pay but did not pay or that it should not have received but did receive. Payments made under division (D)(1) of this section shall be made from the hospital care assurance program fund. Amounts recovered under division (D)(2) of this section shall be deposited to the credit of... |
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Section 5168.13 | Confidentiality.
...of medicaid or by any person under contract with the department who has access to such information. |
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Section 5168.14 | Providing basic, medically necessary hospital-level services to individuals who are residents.
...(A) Each hospital that receives funds distributed under sections 5168.01 to 5168.14 of the Revised Code shall provide, without charge to the individual, basic, medically necessary hospital-level services to individuals who are residents of this state, are not medicaid recipients, and whose income is at or below the federal poverty line. The medicaid director shall adopt rules under section 5168.02 of the Revised Code... |
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Section 5168.20 | Definitions for R.C. 5168.20 to 5168.28.
...As used in sections 5168.20 to 5168.28 of the Revised Code: (A) "Applicable assessment percentage" means the percentage specified in rules adopted under section 5168.26 of the Revised Code that is used in calculating a hospital's assessment under section 5168.21 of the Revised Code. (B) "Assessment program year" means the twelve-month period beginning the first day of October of a calendar year and ending the last ... |
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Section 5168.21 | Additional annual assessment.
...(A) For the purposes specified in section 5168.25 of the Revised Code and subject to section 5168.28 of the Revised Code, there is hereby imposed an assessment on all hospitals each assessment program year. The amount of a hospital's assessment for an assessment program year shall equal the applicable assessment percentage of the hospital's total facility costs for the period of time specified in division (B) of this... |
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Section 5168.22 | Preliminary determination of assessment amount.
...(A) Before or during each assessment program year, the department of medicaid shall issue to each hospital the preliminary determination of the amount that the hospital is assessed under section 5168.21 of the Revised Code for the assessment program year. Except as provided in division (B) of this section, the preliminary determination becomes the final determination for the assessment program year fifteen days after... |
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Section 5168.23 | Assessment payment schedule.
.... The department shall consult with the Ohio hospital association before establishing the payment schedule for any assessment program year. The department shall include the payment schedule in each preliminary determination notice the department issues to hospitals under division (A) of section 5168.22 of the Revised Code. |
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Section 5168.24 | Audit.
...Revised Code. The department shall take action to recover from a hospital any amount the audit reveals that the hospital should have paid but did not pay. |
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Section 5168.25 | Hospital assessment fund.
...There is hereby created in the state treasury the hospital assessment fund. All installment payments made by hospitals under section 5168.23 of the Revised Code and all recoveries the department of medicaid makes under section 5168.24 of the Revised Code shall be deposited into the fund. All investment earnings of the fund shall be credited to the fund. The department shall use money in the fund to pay for the costs ... |
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Section 5168.26 | Excluded costs.
...d under Title V of the "Social Security Act," 42 U.S.C. 701 et seq. (b) Any other category of hospital costs the director deems appropriate under federal law and regulations governing the medicaid program. (2) Subject to division (C) of this section, provide for the percentage of hospitals' total facility costs used in calculating hospitals' assessments to vary for different hospitals. (C) Before adopting ru... |
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Section 5168.27 | Implementation shall not cause reduction in federal participation for medicaid program.
...caid program under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w). |
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Section 5168.28 | Determination of assessment as impermissible health care-related tax.
...-related tax under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w), the medicaid director shall take all necessary actions to cease implementation of sections 5168.20 to 5168.27 of the Revised Code and shall promptly refund to each hospital the amount of money in the hospital assessment fund at the time the refund is to be made that the hospital paid under section 5168.23 of the Revised Code, plus any ... |
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Section 5168.40 | Franchise permit fee definitions.
...ntage specified in the "Social Security Act," section 1903(w)(4)(C)(ii), 42 U.S.C. 1396b(w)(4)(C)(ii), that is to be used in determining whether a class of providers is indirectly held harmless for any portion of the costs of a broad-based health-care-related tax. If the indirect guarantee percentage changes during a fiscal year, the indirect guarantee percentage is the following: (1) For the part of the fiscal ye... |
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Section 5168.41 | Determination of nursing home and hospital long-term care franchise permit fee rate.
...(A) The franchise permit fee rate shall be determined for each fiscal year as follows: (1) Determine the estimated total net patient revenues for all nursing homes and hospital long-term care units for the fiscal year; (2) Multiply the estimated total net patient revenues determined under division (A)(1) of this section by the lesser of the following: (a) The indirect guarantee percentage; (b) Six per cent.... |
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Section 5168.42 | Annual franchise permit fee.
...he indirect guarantee percentage of the actual net patient revenue for all nursing homes and hospital long-term care units for that fiscal year and seventy-five per cent or more of the combined total number of nursing homes and hospital long-term care units receive enhanced medicaid payments or other state payments equal to seventy-five per cent or more of their total franchise permit fee assessments, do both o... |