Ohio Revised Code Search

...rve the region. (D) In an adjudication conducted in accordance with Chapter 119. of the Revised Code, the state ombudsman may issue an adjudication order withdrawing or provisionally maintaining the designation of an entity as a regional program if it ceases to meet the criteria established pursuant to division (B) of this section or a conflict of interest develops between the regional program or a person associated...

...chnical assistance to regional programs conducting training for volunteers and shall monitor the training. (E) Notwithstanding the requirements for a certification under this section, the department shall issue a certificate as a representative of the office of the state long-term care ombudsman program in accordance with Chapter 4796. of the Revised Code to a person if either of the following applies: (1) The ...

...B)(2) of section 173.391 of the Revised Code are public records for purposes of section 149.43 of the Revised Code and shall be made available on request of any person, including individuals receiving or seeking any services, including community-based long-term care services, under a program the department of aging administers. (B) A part of a record of an evaluation that is otherwise available as a public record u...

...ssistance may include providing for the conduct of assessments or other evaluations and the development of individualized plans of care or services under section 173.424 of the Revised Code. (K) No nursing facility for which an operator has a provider agreement under section 5165.07, 5165.511, or 5165.512 of the Revised Code shall admit as a resident any individual described in division (G) of this section, unless ...

...tions 173.42 and 173.421 of the Revised Code. The director of aging shall adopt rules in accordance with Chapter 119. of the Revised Code governing the certification process and requirements. The rules shall specify the education, experience, or training in long-term care a person must have to qualify for certification. (B) Notwithstanding the requirements for a certification under division (A) of this section, the...

...ts of the customer satisfaction surveys conducted under section 173.47 of the Revised Code; (4) Any other information the department specifies in rules adopted under section 173.49 of the Revised Code. (C) The Ohio long-term care consumer guide may include information on residential facilities and providers of community-based long-term care services. The department may adopt rules under section 173.49 of the R...

...ed under section 173.546 of the Revised Code; (B) While receiving assisted living services under the medicaid-funded component, reside in a residential care facility that is authorized by a valid medicaid provider agreement to participate in the component, including both of the following: (1) A residential care facility that is owned or operated by a metropolitan housing authority that has a contract with the ...

...ed under section 173.546 of the Revised Code. (B) The individual must have an application for the medicaid-funded component of the assisted living program pending and the department or the department's designee must have determined that the individual meets the nonfinancial eligibility requirements of the medicaid-funded component and not have reason to doubt that the individual meets the financial eligibility req...

...sentation of material facts or criminal conduct toward the insurer, small employer, or alliance under the program; (9) Premium rate structures, which may be uniform or make provision for age-specific rates, differentials based on number of participants of an enrolled small employer, products and plan options selected, and other factors, rate adjustments based on consumer price indices, utilization, or other relevant...

...ved and utilized by outside auditors in conducting audits under section 1733.19 of the Revised Code. The accounting principles and practices prescribed for outside auditors may exceed those otherwise prescribed in rules adopted under section 1733.41 of the Revised Code, but shall be generally in accordance with accepted accounting principles as defined by the American institute of certified public accountants.

...ce with section 109.572 of the Revised Code. The superintendent of credit unions shall request that criminal record information from the federal bureau of investigation be obtained as part of the criminal records check. Any fee required under division (C)(3) of section 109.572 of the Revised Code shall be paid by the person who is the subject of the request.

...eement, written, oral, or inferred from conduct, for one or more common, nonprofit purposes. "Unincorporated nonprofit association" does not include any of the following: (1) A trust; (2) A marriage, domestic partnership, common law relationship, or other domestic living arrangement; (3) An organization that is formed under any other statute that governs the organization and operation of unincorporated associat...

...tion of its programs and annually shall conduct at least one public hearing to obtain input from any interested party regarding the administration of its programs. The hearing shall be held at a time and place as the agency determines and when a quorum of the agency is present. (E) The agency shall appoint committees and subcommittees comprised of members of the agency to handle matters it deems appropriate. (1) ...

...al cost certification and the appraisal conducted under this division. (E) Each eligibility certificate shall state the annual credit amount, the years that comprise the credit period, the name, address, and the taxpayer identification number of the project development owner, the project development owner's designated reporter, and all members of the project development team along with the date the certificate is ...

...ate of authority under this chapter to conduct its business. (I) The superintendent shall not issue a certificate of authority to a health insuring corporation that is a provider sponsored organization unless all health care plans to be offered by the health insuring corporation provide basic health care services. Substantially all of the physicians and hospitals with ownership or control of the provider spons...

...t: (1) The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy, and possess good reputations. (2) The superintendent determines, in accordance with division (B) of section 1751.04 of the Revised Code, that the organization's proposed plan of operation meets the requirements of division (A) of that section. (3) The applicant constitutes an appropriate mechanism to ...

...r and evaluate the quality of care, to conduct evaluations and audits, and to determine on a concurrent or retrospective basis the necessity of and appropriateness of health care services provided to enrollees. The provision shall include terms requiring the provider or health care facility to make these health records available to appropriate state and federal authorities involved in assessing the quality of ...

...sses of the persons responsible for the conduct of the affairs of the health insuring corporation as required by section 1751.03 of the Revised Code. Additionally, the report shall include the amount of wages, expense reimbursements, and other payments to these persons for services to the health insuring corporation, and shall include a full disclosure of the financial interests related to the operations of the healt...

...tions 3901.19 to 3901.26 of the Revised Code. (D) This section does not do any of the following: (1) Require a policy, contract, or agreement to cover inpatient or follow-up care that is not received in accordance with the policy's, contract's, or agreement's terms pertaining to the providers and facilities from which an individual is authorized to receive health care services; (2) Require a mother or newborn to s...

...ective or utilization review procedures conducted prior to providing a health care service, device, or drug. (9) "Urgent care services" means a medical care or other service for a condition where application of the timeframe for making routine or non-life threatening care determinations is either of the following: (a) Could seriously jeopardize the life, health, or safety of the patient or others due to the patient...

...ave operational responsibility for the conduct of the health insuring corporation's utilization review program. (2) If a health insuring corporation contracts to have a utilization review organization or other entity perform the utilization review functions required by sections 1751.77 to 1751.87 and Chapter 3922. of the Revised Code, and any rules adopted thereunder, the superintendent of insurance shall hold...

... collect-call telephone line. (F) When conducting prospective or concurrent review, the health insuring corporation or its designee utilization review organization shall collect only the information necessary to certify the admission, procedure or treatment, length of stay, frequency, and duration of health care services. (G) Compensation to persons providing utilization review services for the health insuring corp...

...ration's possession related to reviews conducted pursuant to this section, including medical records related to those reviews, and of responses, for three years following completion of the review.

...G)(2) of section 3963.02 of the Revised Code, except that, notwithstanding any provision of a contract described in that division, this section applies to the termination of a participating provider's contract for any of the causes described in divisions (A), (D), and (F)(1) and (2) of this section. (G) The superintendent of insurance may adopt rules as necessary to implement and enforce sections 1753.06, 1753.07, ...

...B)(2) of section 1753.34 of the Revised Code, and a corrective order issued pursuant to division (B)(3) of section 1753.34 of the Revised Code. A disclosure to the superintendent of these plans, reports, information, and orders does not constitute a waiver of any applicable privilege or claim of confidentiality in the plans, reports, information, and orders. (B) Notwithstanding division (A) of this section: (1) Th...