Ohio Revised Code Search

...As used in sections 5168.75 to 5168.86 of the Revised Code: (A) "Basic health care services" means all of the services listed in division (A)(1) of section 1751.01 of the Revised Code. (B) "Care management system" has the same meaning as in section 5167.01 of the Revised Code. (C) "Dual eligible individual" has the same meaning as in section 5160.01 of the Revised Code. (D) "Franchise fee" means the fee impos...

...(A) For the purposes specified in section 5168.85 of the Revised Code and subject to sections 5168.82, 5168.83, 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 medi...

...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 ...

...The department of medicaid may request that a health insuring corporation provide the department documentation the department 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 pr...

...If the department of medicaid 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.

...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...

...If a health insuring corporation fails to pay 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.

...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).

...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...

...If the United States centers for medicare and medicaid 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 ...

...(A) There is hereby created in the state treasury the health insuring corporation franchise fee fund. All payments and penalties paid by health insuring corporations under sections 5168.77, 5168.79, and 5168.81 of the Revised Code shall be deposited into the fund. money in the fund shall be used to make medicaid payments to medicaid providers and medicaid managed care organizations. (B) Any interest or other investm...

...The medicaid director may adopt rules in accordance with Chapter 119. as necessary to implement sections 5168.75 to 5168.86 of the Revised Code.

...(A) At least quarterly, the medicaid director shall report to the members of the joint medicaid oversight committee and the executive director of the joint medicaid oversight committee both of the following: (1) The fee rates and the aggregate total of the fees assessed for each of the following: (a) The hospital assessment established under section 5168.21 of the Revised Code; (b) The nursing home and hospital...

...(A) The medicaid director shall impose a penalty for each day that a hospital fails to report the information required under section 5168.05 of the Revised Code on or before the dates specified in that section. The amount of the penalty shall be established by the director in rules adopted under section 5168.02 of the Revised Code. (B) In addition to any other remedy available to the department of medicaid under law...

...The department of medicaid may offset the amount of a hospital's unpaid penalty imposed under section 5168.99 of the Revised Code from one or more payments due the hospital under the medicaid program. The total amount that may be offset from one or more payments shall not exceed the amount of the unpaid penalty.

...ead start, preschool special education, publicly funded child care, and the step up to quality program; (4) Maternal and child physical health, including, but not limited to, infant vitality, home visiting, maternal and child health, maternal and infant support, and Medicaid-funded child health services.

...ode; (2) Approving and entering into contracts, agreements, and other business arrangements on behalf of the department; (3) Making as necessary appointments to the department and approving actions related to departmental employees and officers, including their hiring, promotion, termination, discipline, or investigation; (4) Administering the department and directing the performance of its employees and off...

...dministered by local or community-based public or private entities and, to the extent they do not, whether they should. (3) With assistance from academic medical centers, track and analyze infant mortality rates by county for the purpose of determining the impact of state and local initiatives to reduce those rates. (C) The commission shall consist of the following members: (1) Two members of the senate, one...

...(A) As used in this section: (1) "Preliminary infant mortality and preterm birth rates" means infant mortality and preterm birth rates that are derived from vital records as defined in section 3705.01 of the Revised Code, are not considered finalized by the department of health, and are subject to modification as additional birth and death data are received by the department and added to vital records. (2) "Sti...

...(A) As used in this section, "stillbirth" means death prior to the complete expulsion or extraction from its mother of a product of human conception of at least twenty weeks of gestation, which after such expulsion or extraction does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. (B) The director of children a...

...eal time on a data dashboard to be made publicly available. (C) The scorecard shall include a description of the data sources and methodology used to complete the scorecard.

...al materials to determine if updates or improvements should be made; (c) Reviewing the manner in which the educational materials are distributed, as described in section 5180.15 of the Revised Code, to determine if modifications to that manner should be made. (C) In meeting the requirements under division (B) of this section, the director shall develop educational materials that, to the extent possible, minimiz...

..., to each of its employees; (6) By a public children services agency, when the agency has initial contact with an infant's parent, guardian, or other person responsible for the infant. (B) An entity or person required to distribute educational materials pursuant to division (A) of this section is not liable for damages in a civil action for injury, death, or loss to person or property that allegedly arises from...

...(A) As used in this section, "sudden unexpected infant death" means the death of an infant that occurs suddenly and unexpectedly, the cause of which is not immediately obvious prior to investigation. (B) The department of children and youth shall establish the safe sleep education program by doing all of the following: (1) Developing educational materials that present readily comprehendible information on safe ...

...s section, makes suggestions for system improvements, and provides any other information the director considers appropriate for inclusion in the report. On completion, the report shall be submitted to the general assembly with, and in the same manner as, the report that the department of medicaid submits to the general assembly and joint medicaid oversight committee pursuant to section 5162.13 of the Revised Code. A ...