Ohio Revised Code Search
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Section 5168.54 | Nursing home franchise permit fee fund.
... also be used for the residential state supplement program established under section 5119.41 of the Revised Code. (B) Any money remaining in the nursing home franchise permit fee fund after payments specified in division (A) of this section are made shall be retained in the fund. Any interest or other investment proceeds earned on money in the fund shall be credited to the fund and used to make medicaid payments i... |
Section 5168.55 | Investigations; enforcement.
...ch a nursing home or hospital that has failed to comply with sections 5168.40 to 5168.56 of the Revised Code is located shall institute and prosecute any necessary action against the nursing home or hospital. |
Section 5168.56 | Implementing provisions.
...r shall adopt rules in accordance with Chapter 119. of the Revised Code to do both of the following: (A) Prescribe the actions the department of medicaid will take to cease implementation of sections 5168.40 to 5168.56 of the Revised Code if the United States centers for medicare and medicaid services determines that the franchise permit fee established by those sections is an impermissible health-care relat... |
Section 5168.60 | Definitions for R.C. 5168.60 to 5168.71.
...ction 5168.61 of the Revised Code, "franchise permit fee rate" means the following: (1) For fiscal year 2020, twenty-three dollars and ninety-five cents; (2) For fiscal year 2021 and each fiscal year thereafter, twenty-four dollars and eighty-nine cents. (B) "Indirect guarantee percentage" means the percentage specified in the "Social Security Act," section 1903(w)(4)(C)(ii), 42 U.S.C. 1396b(w)(4)(C)(ii), that ... |
Section 5168.61 | ICF/IID quarterly franchise permit fees.
...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 submitted to the department under section 5168.62 of the Revised Code. (B) If the total amount of the franchise permit fee assessed under division (A) of this sect... |
Section 5168.62 | Monthly report.
...eport for accuracy. (B) If an ICF/IID fails to submit a report for a month, the number of its inpatient days for that month shall be the product of the following: (1) The ICF/IID's medicaid-certified capacity; (2) The number of days in the month. |
Section 5168.63 | Determination, notice and payment of quarterly franchise permit fee.
...(A) Not later than the last day of each October, January, April, and July, the department of developmental disabilities shall notify, electronically or by United States postal service, each ICF/IID of the amount of the quarterly franchise permit fee the ICF/IID has been assessed under section 5168.61 of the Revised Code. (B) Subject to section 5168.64 of the Revised Code, each ICF/IID shall pay its quarterly franch... |
Section 5168.64 | Consequences of converting beds to providing home and community-based services.
...ities shall terminate the ICF/IID's franchise permit fee effective on the first day of the quarter immediately following the quarter in which the conversion takes place. |
Section 5168.65 | Assessing penalty for overdue installment.
...r cent penalty on the amount due for each month or fraction thereof the installment is overdue. |
Section 5168.66 | Additional sanctions for overdue installment.
...D fails to pay the full amount of a franchise permit fee installment when due: (1) Withhold an amount less than or equal to the installment and penalty assessed under section 5168.65 of the Revised Code from a medicaid payment due the ICF/IID until the ICF/IID pays the installment and penalty; (2) Offset an amount less than or equal to the installment and penalty assessed under section 5168.65 of the Revised ... |
Section 5168.67 | Appeal of fee.
...(A) An ICF/IID may appeal the franchise permit fee imposed under section 5168.61 of the Revised Code solely on the grounds that the department of developmental disabilities committed a material error in determining the amount of the fee. A request for an appeal must be received by the department not later than fifteen days after the date the department notifies the ICF/IID of the fee and must include written material... |
Section 5168.68 | Home and community-based services for persons with developmental disabilities fund.
... As soon as possible after the end of each quarter, the medicaid director shall certify to the director of budget and management the amount of money that is in the fund as of the last day of that quarter. On receipt of a certification, the director of budget and management shall transfer the amount so certified from the home and community-based services for persons with developmental disabilities fund to the departme... |
Section 5168.69 | Department of developmental disabilities operating and services fund.
...There is hereby created in the state treasury the department of developmental disabilities operating and services fund. The fund shall consist of the money transferred to it under section 5168.68 of the Revised Code. The money in the fund shall be used for the expenses of the programs that the department of developmental disabilities administers and the department's administrative expenses. |
Section 5168.70 | Investigation; enforcement.
...he county in which an ICF/IID that has failed to comply with those sections is located shall institute and prosecute any necessary action against the ICF/IID. |
Section 5168.71 | Adoption of rules.
...s shall adopt rules in accordance with Chapter 119. of the Revised Code to do both of the following: (A) Prescribe the actions the department of developmental disabilities will take to cease implementation of sections 5168.60 to 5168.71 of the Revised Code if the United States secretary of health and human services determines that the franchise permit fee imposed under section 5168.61 of the Revised Code is an... |
Section 5168.75 | Definitions for R.C. 5168.75 to 5168.86.
...for, or otherwise makes available, only supplemental health care services or only specialty health care services. (F) "Health insuring corporation plan" means a policy, contract, certificate, or agreement of a health insuring corporation under which the corporation pays for, reimburses, provides, delivers, arranges for, or otherwise makes available basic health care services. "Health insuring corporation plan" does... |
Section 5168.76 | Franchise fee on health insuring corporation plans.
... and 5168.84 of the Revised Code, a franchise fee is hereby imposed each month beginning with July 2017 on each health insuring corporation plan. The franchise fee shall have a component based on Ohio medicaid member months and another component based on other Ohio member months. (B) The department of medicaid shall determine the amount of the monthly franchise fee to be imposed on a health insuring corporation p... |
Section 5168.77 | Component due dates.
...The component of the monthly franchise fee based on Ohio medicaid member months is due not later than the fifth business day of the month immediately following the month for which it is imposed. The component of the monthly franchise fee based on other Ohio member months is due not later than the last day of September of the calendar year in which the rate year ends, and the total amount due under that component for ... |
Section 5168.78 | Documentation.
...t needs to verify the amount of the franchise fees imposed on the health insuring corporation plans administered by the corporation and to ensure the corporation's compliance with sections 5168.75 to 5168.86 of the Revised Code. On receipt of the request, the health insuring corporation shall provide the department the requested documentation. The department also may review relevant documentation possessed by other e... |
Section 5168.79 | Determination of higher fee.
...aid determines that the amount of a franchise fee that a health insuring corporation paid is less than the amount it should have paid, the department shall notify the health insuring corporation. Except as otherwise provided by the results of a reconsideration conducted under section 5168.80 of the Revised Code, the health insuring corporation shall pay the amount due. |
Section 5168.80 | Request for reconsideration.
...A health insuring corporation may request a reconsideration of a determination made by the department of medicaid under section 5168.79 of the Revised Code. A reconsideration may be requested solely on the grounds that the department made a material error in making the determination. A request for a reconsideration must be received by the department not later than fifteen days after the date the department notifies t... |
Section 5168.81 | Penalty for overdue payments.
...the full amount of a component of a franchise fee when due, the department of medicaid may assess a ten per cent penalty on the amount due for each month or fraction thereof that the component of the franchise fee is overdue. |
Section 5168.82 | Waiver required.
...The franchise fee shall not be imposed on any health insuring corporation plan unless there is in effect a waiver authorizing the franchise fee issued by the United States secretary of health and human services pursuant to section 1903(w)(3)(E) of the "Social Security Act," 42 U.S.C. 1396b(w)(3)(E). |
Section 5168.83 | Refunds.
...If the total amount of franchise fees imposed on all health insuring corporation plans under section 5168.76 of the Revised Code during a fiscal year exceeds the indirect guarantee percentage of the net patient revenue for all health insuring corporations for that fiscal year and seventy-five per cent or more of all health insuring corporations receive enhanced medicaid payments or other state payments equal to seven... |
Section 5168.84 | Modification or cessation.
...dicaid services determines that the franchise fee is an impermissible health care-related tax under section 1903(w) of the "Social Security Act," 42 U.S.C. 1396b(w), the department of medicaid shall do either of the following as appropriate: (A) Modify the imposition of the franchise fee, including (if necessary) the amount of the franchise fee, in a manner needed for the United States centers to reverse its determi... |