Ohio Revised Code Search

...(A) Whoever violates section 5123.16 or 5123.20 of the Revised Code is guilty of a misdemeanor of the first degree. (B) Whoever violates division (C), (E), or (G)(3) of section 5123.61 of the Revised Code is guilty of a misdemeanor of the fourth degree or, if the abuse or neglect constitutes a felony, a misdemeanor of the second degree. In addition to any other sanction or penalty authorized or required by law, if a...

...The department of medicaid shall enter into a contract with the department of developmental disabilities under section 5162.35 of the Revised Code that provides for the department of developmental disabilities to assume the powers and duties of the department of medicaid with regard to the medicaid program's coverage of ICF/IID services. The contract shall include a schedule for the assumption of the powers and...

...To the extent authorized by rules authorized by section 5162.021 of the Revised Code, the director of developmental disabilities shall adopt rules in accordance with Chapter 119. of the Revised Code as necessary to implement this chapter.

...The medicaid program shall cover ICF/IID services when all of the following apply: (A) The ICF/IID services are provided to a medicaid recipient eligible for the services. (B) The ICF/IID services are provided by an ICF/IID for which the provider has a valid provider agreement. (C) Federal financial participation is available for the ICF/IID services.

...(A) Subject to section 5124.072 of the Revised Code, an ICF/IID operator is eligible to enter into a provider agreement for an ICF/IID if all of the following apply: (1) The ICF/IID is certified by the director of health for participation in medicaid; (2) The ICF/IID is licensed by the director of developmental disabilities as a residential facility; (3) Subject to division (B) of this section, the operator a...

...d Code; (2) Keep records relating to a cost reporting period for the greater of seven years after the cost report is filed or, if the department of developmental disabilities issues an audit report in accordance with section 5124.109 of the Revised Code, six years after all appeal rights relating to the audit report are exhausted; (3) File reports as the department of developmental disabilities requires; (4)...

...An ICF/IID operator may enter into provider agreements for more than one ICF/IID.

...The department of medicaid shall not revalidate an ICF/IID provider agreement if the provider fails to maintain eligibility for the provider agreement as provided in section 5124.06 of the Revised Code.

...(A) Every provider agreement with an ICF/IID provider shall do both of the following: (1) Except as provided by division (B) of this section, include any part of the ICF/IID that meets federal and state standards for medicaid certification; (2) Prohibit the provider from doing either of the following: (a) Discriminating against a resident on the basis of race, color, sex, creed, or national origin; (b) Subje...

...on behalf of a resident actual damages, costs, and reasonable attorney's fees.

...of developmental disabilities an annual cost report for each of the provider's ICFs/IID for which the provider has a valid provider agreement. The cost report for a year shall cover the calendar year or portion of the calendar year during which the ICF/IID participated in the medicaid program. Except as provided in division (E) of this section, the cost report is due not later than ninety days after the end of the ca...

...artment of developmental disabilities a cost report covering the period specified in division (B) of this section if the following applies to the ICF/IID: (1) In the case of an ICF/IID that becomes a downsized ICF/IID or partially converted ICF/IID, the ICF/IID has either of the following on the day it becomes a downsized ICF/IID or partially converted ICF/IID: (a) A medicaid-certified capacity that is at least t...

...ection 5124.99 of the Revised Code in a cost report filed under section 5124.10, 5124.101, or 5124.522 of the Revised Code.

...Cost reports shall be completed using the form prescribed under section 5124.104 of the Revised Code and in accordance with the guidelines established under that section.

...be the form to be used for completing a cost report and a uniform chart of accounts for the purpose of reporting costs on the form; (B) Distribute a paper copy of the form, or computer software for electronic submission of the form, to each provider at least sixty days before the date the cost report is due; (C) Establish guidelines for completing the form.

...ities shall develop an addendum to the cost report form that an ICF/IID provider may use to set forth costs that the provider believes the department may dispute. The department may consider such costs in determining an ICF/IID's medicaid payment rate. If the department does not consider such costs in determining an ICF/IID's medicaid payment rate, the provider may seek reconsideration of the determination in ...

...n 5124.10 of the Revised Code to file a cost report for the ICF/IID fails to file the cost report by the date it is due or the date, if any, to which the due date is extended pursuant to division (E) of that section, or files an incomplete or inadequate report for the ICF/IID under that section, the department of developmental disabilities shall do both of the following: (1) Give written notice to the provider...

...ears after an ICF/IID provider files a cost report with the department of developmental disabilities under section 5124.10 or 5124.101 of the Revised Code, the provider may amend the cost report if the provider discovers a material error in the cost report or additional information to be included in the cost report. The department shall review the amended cost report for accuracy and notify the provider of its...

...ies shall conduct a desk review of all cost reports it receives under sections 5124.10, 5124.101, and 5124.522 of the Revised Code. Based on the desk review, the department shall make a preliminary determination of whether the reported costs are allowable costs. The department shall notify each ICF/IID provider of whether any of the reported costs are preliminarily determined not to be allowable costs, the med...

... by the American institute of certified public accountants; (iii) Include a written summary as to whether the costs included in the cost report examined during the audit are allowable and are presented in accordance with state and federal laws and regulations, and whether, in all material respects, allowable costs are documented, reasonable, and related to patient care; (iv) Complete the audit within the time...

... (2) The per medicaid day direct care costs component rate determined for the ICF/IID under section 5124.19 of the Revised Code; (3) The per medicaid day indirect care costs component rate determined for the ICF/IID under section 5124.21 of the Revised Code; (4) The per medicaid day other protected costs component rate determined for the ICF/IID under section 5124.23 of the Revised Code; (5) The sum of the...

...he initial per medicaid day direct care costs component rate shall be determined as follows: (a) If there are no cost or resident assessment data for the new ICF/IID as necessary to determine a rate under section 5124.19 of the Revised Code, the rate shall be determined as follows: (i) Determine the median cost per case-mix unit under division (B) of section 5124.19 of the Revised Code for the new ICF/IID's pee...

...ny other provision of this chapter, the costs incurred by a designated outlier ICF/IID or unit shall not be considered in establishing medicaid payment rates for other ICFs/IID or units. (D) The director of developmental disabilities shall adopt rules under section 5124.03 of the Revised Code as necessary to implement this section. (1)(a) The rules shall do both of the following: (i) Specify the criteria and pr...

...(A) To the extent, if any, provided for in rules authorized by this section, the total per medicaid day payment rate determined under section 5124.15 of the Revised Code shall not be paid for ICF/IID services that an ICF/IID not designated as an outlier ICF/IID or unit provides to a resident who meets the criteria for admission to a designated outlier ICF/IID or unit, as specified in rules authorized by section...

...tal centers according to the reasonable cost principles of Title XVIII.