Ohio Revised Code Search

...ins or collects shall be specified in a contract the department enters into with the state agency or political subdivision under section 5162.35 of the Revised Code. (B) All amounts the department retains or collects under this section shall be deposited into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code.

...to pay for other medicaid services and contracts.

...nts, investment accounts, partnerships, contracts, and other similar arrangements that are not called trusts under state law but are similar to a trust and to which all of the following apply: (a) The property in the trust is held, managed, retained, or administered by a trustee. (b) The trustee has an equitable, legal, or fiduciary duty to hold, manage, retain, or administer the property for the benefit of the ben...

...of medicaid shall enter into a separate contract with the department of mental health and addiction services under section 5162.35 of the Revised Code with regard to the mental health services the medicaid program covers pursuant to this section.

... or political subdivision pursuant to a contract entered into under section 5162.35 of the Revised Code. The departments of aging, developmental disabilities, and mental health and addiction services shall participate in the development of the revisions and shall utilize the revised system.

...o, any other medicaid provider or risk contractor; (2) Arrange for, render, or order services for medicaid recipients during the period of exclusion; (3) During the period of exclusion, receive direct payments under the medicaid program or indirect payments of medicaid funds in the form of salary, shared fees, contracts, kickbacks, or rebates from or through any other medicaid provider or risk contractor. (C...

... of any other medicaid provider or risk contractor or arrange for, render, or order medicaid services for medicaid recipients, nor shall such provider, owner, officer, authorized agent, associate, manager, or employee receive direct payments under the medicaid program or indirect payments of medicaid funds in the form of salary, shared fees, contracts, kickbacks, or rebates from or through any other medicaid provider...

...Own any other medicaid provider or risk contractor; (ii) Arrange, render, or order services on behalf of any other medicaid provider or risk contractor; (iii) Arrange or order services for medicaid recipients or render services to medicaid recipients; (iv) Receive direct payments under the medicaid program or indirect payments of medicaid funds in the form of salary, shared fees, contracts, kickbacks, or reb...

...tering into or refusing to enter into a contract with a managed care organization pursuant to section 5167.10 of the Revised Code; (2) Any action taken by the department under division (D)(2) of section 5124.60, division (D)(1) or (2) of section 5124.61, or sections 5165.60 to 5165.89 of the Revised Code. (C) Except as provided in division (E) of this section and section 5164.58 of the Revised Code, the departm...

...d program and is not employed by, under contract with, or affiliated with another entity that provides the services. (3) "Nursing services" means all of the following: (a) Nursing services covered by the medicaid program as part of the home health services benefit pursuant to 42 C.F.R. 440.70(b)(1); (b) Private duty nursing services, as defined in 42 C.F.R. 440.80, covered by the medicaid program; (c) Nursing...

...) If a state agency that enters into a contract with the department of medicaid under section 5162.35 of the Revised Code identifies that a medicaid overpayment has been made to a medicaid provider, the state agency may commence actions to recover the overpayment on behalf of the department. (B) In recovering an overpayment pursuant to this section, a state agency shall comply with the following procedures: (...

...eal and a clinical peer appointed by or contracted by the department or the department's designee. (4) If the department does not either grant or deny an exemption request or an appeal within the time frames prescribed in division (B)(1) or (2) of this section, then such an exemption request or appeal shall be deemed to be granted. (C) If an appeal is rejected, the medicaid recipient in question may make a furth...

... for that year by an organization under contract with the United States department of health and human services.

...to or designated in any statute, rule, contract, provider agreement, or other document pertaining to the medicaid program, the reference or designation is deemed to refer to a nursing facility. (B) A reference to or designation of an "intermediate care facility for individuals with intellectual disabilities" or "ICF/IID" is not deemed to refer to a nursing facility.

...A nursing facility operator may enter into provider agreements for more than one nursing facility.

...e to persons with whom the provider has contracted to provide continuing care; (3) If the nursing facility is a county home organized under Chapter 5155. of the Revised Code, admitting residents exclusively from the county in which the county home is located; (4) Retaining residents who have resided in the provider's nursing facility for not less than one year as private pay patients and who subsequently become med...

...nalties, notification for correction of contract violations, and history of deficiencies. (B) Division (A)(3) of this section does not prohibit a nursing facility provider from excluding one or more parts of the nursing facility from the provider agreement pursuant to division (B)(1) of section 5165.08 of the Revised Code.

...ng documents, and fully executed sales contracts and any other supporting documents culminating in the change of operator; (C) The method by which the forms and documents identified in division (B) of this section are to be provided to the department.

...force the sections directly or through contracting agencies. The department and agencies shall enforce the sections in accordance with the requirements of the "Social Security Act," sections 1819 and 1919, 42 U.S.C. 1395i-3 and 1396r, that apply to nursing facilities; with regulations, guidelines, and procedures adopted by the United States secretary of health and human services for the enforcement of those sec...

...action by the department of medicaid or contracting agency under this chapter or is an action by any department or agency of the state to enforce this chapter or another chapter of the Revised Code; (B) An advertisement, unless the advertisement includes all of the following: (1) The date the survey was conducted; (2) A statement that the department of health conducts a survey of all nursing facilities at least on...

...ho currently has a consulting or other contract with the department or the facility, shall be appointed as a monitor under this section. Every monitor appointed under this section shall have the professional qualifications necessary to monitor correction of the finding or elimination of the emergency.

...nding, the department of medicaid or a contracting agency may, subject to sections 5165.82 and 5165.83 of the Revised Code, impose one or more of the following remedies: (A) Do either of the following: (1) Issue an order denying medicaid payments to the facility for all medicaid eligible residents admitted after the effective date of the order; (2) Impose a fine. (B) Issue an order denying medicaid payments...

...posed, the department of medicaid or a contracting agency shall do both of the following: (1) Impose the remedies that are most likely to achieve correction of deficiencies, encourage sustained compliance with certification requirements, and protect the health, safety, and rights of facility residents, but that are not directed at punishment of the facility; (2) Consider all of the following: (a) The presenc...

...e time the department of medicaid or a contracting agency, under section 5165.71, 5165.72, or 5165.77 of the Revised Code, issues an order terminating a nursing facility's participation in the medicaid program, the department or agency may also impose a fine, in accordance with sections 5165.72 to 5165.74 and 5165.83 of the Revised Code, to be collected in the event the termination order does not take effect. T...

... quality improvement organization under contract with the United States secretary of health and human services to carry out in this state the functions described in section 1154 of the "Social Security Act," 42 U.S.C. 1320c-3.