Ohio Revised Code Search

...(A) The department of medicaid shall conduct periodic reviews to determine the barriers that medicaid recipients face in gaining full access to interventions intended to reduce tobacco use, prevent prematurity, and promote optimal birth spacing. The first review shall occur not later than sixty days after the effective date of this section. Thereafter, reviews shall be conducted every six months. The department shal...

... department of medicaid shall conduct a cost savings study of the medicaid program and prepare a report based on that study recommending measures to reduce costs under that program. The department shall submit its report to the governor.

...(A) The department of medicaid shall periodically evaluate the success that members of the expansion eligibility group have with the following: (1) Obtaining employer-sponsored health insurance coverage; (2) Improving health conditions that would otherwise prevent or inhibit stable employment; (3) Improving the conditions of their employment, including duration and hours of employment. (B) For the purpose of ...

...(A) As used in this section; "Agent" and "contractor" include any agent, contractor, subcontractor, or other person who, on behalf of an entity, furnishes or authorizes the furnishing of medicaid services, performs billing or coding functions, or is involved in monitoring of health care that an entity provides. "Employee" includes any officer or employee (including management employees) of an entity. "Entity...

...A government entity that administers one or more components of the medicaid program and has reasonable cause to believe that an instance of fraud, waste, or abuse has occurred in the medicaid program shall inform the department of medicaid. The department shall collect the information in the medicaid data warehouse system established under section 5162.11 of the Revised Code.

... department of medicaid shall institute cost-sharing requirements for the medicaid program. The department shall not institute cost-sharing requirements in a manner that does either of the following: (1) Disproportionately impacts the ability of medicaid recipients with chronic illnesses to obtain medically necessary medicaid services; (2) Violates section 5164.09 or 5164.10 of the Revised Code. (B)(1) No provi...

...vices in the institution, to spend for costs of medical or nursing care all of the individual's income except for an amount for personal needs specified by the department of medicaid; (c) Cannot reasonably be expected to be discharged from the institution and return home as determined by the department of medicaid. (4) "Qualified state long-term care insurance partnership program" means the program establishe...

...riority of its lien to provide for the costs of the last illness as determined by the department, administration, attorney fees, administrator fees, a sum for the payment of the costs of burial, which shall be computed by deducting from five hundred dollars whatever amount is available for the same purpose from all other sources, and a similar sum for the spouse of the decedent. (E) A lien imposed with respect...

...ederal financial participation for the costs incurred in entering into the contract and carrying out actions under the contract. The contract may provide for the person or government entity with which the attorney general contracts to be compensated from the property recovered under the medicaid estate recovery program or may provide for another manner of compensation agreed to by the parties to the contract. ...

...esident are inadequate to pay the full cost of the expenses, the money in the resident's personal needs allowance account shall be used to pay for the expenses rather than being transferred to the department of medicaid pursuant to division (B) of this section. (D) If, not later than sixty days after a resident of a home or residential facility dies, letters testamentary or letters of administration are issued...

...(A) The medicaid director shall adopt rules under section 5162.02 of the Revised Code permitting county departments of job and family services to take action to recover benefits incorrectly paid on behalf of medicaid recipients. The rules shall provide for recovery by the following methods: (1) Soliciting voluntary payments from recipients or from persons holding property in which a recipient has a legal or e...

... the extent necessary to reimburse its costs, garnish the wages, salary, or other employment income of, and withhold amounts from state tax refunds to, any person to whom both of the following apply: (1) The person is required by a court or administrative order to provide coverage of the cost of health care services to a child eligible for medicaid. (2) The person has received payment from a third party for ...

...tion is received for the administrative costs incurred by the department of health and the Arthur G. James cancer hospital and Richard J. Solove research institute of the Ohio state university in analyzing and evaluating both of the following pursuant to sections 3701.261 and 3701.262 of the Revised Code: (1) Cancer reports under the Ohio cancer incidence surveillance system; (2) The incidence, prevalence, c...

...Local funds, whether from public or private sources, expended by a county department of job and family services for administration of the healthy start component shall be considered to have been expended by the state for the purpose of determining the extent to which the state has complied with any federal requirement that the state provide funds to match federal financial participation for the medicaid program...

...The department of medicaid may enter into contracts with political subdivisions to use funds of the political subdivision to pay the nonfederal share of expenditures under the medicaid program. The determination and provision of federal financial participation to a subdivision entering into a contract under this section shall be determined by the department, subject to section 5162.40 of the Revised Code.

...artment for the nonfederal share of the cost to the department of performing, or contracting for the performance of, a fiscal audit of the component of the medicaid program, or aspect of the component, that the state agency or political subdivision administers if rules governing the component, or aspect of the component, require that a fiscal audit be conducted.

...The medicaid director shall create, in accordance with sections 5162.36 to 5 162.366 of the Revised Code, the medicaid school component of the medicaid program.

... a claim before the provider incurs the cost of providing the service. The claim shall include certification of the qualified medicaid school provider's expenditures for the service. The certification shall show that the money the qualified medicaid school provider used for the expenditures was nonfederal money the provider may legally use for providing the service and that the amount of the expenditures was suffici...

...l provider the nonfederal share of the cost of the services for which the claim was submitted.

...The department of medicaid shall enter into an interagency agreement with the department of education and workforce under section 5162.35 of the Revised Code that provides for the department of education and workforce to administer the medicaid school component of the medicaid program other than the aspects of the component that sections 5162.36 to 5162.366 of the Revised Code require the department of medicaid to ad...

...The medicaid director shall adopt rules under section 5162.02 of the Revised Code as necessary to implement the medicaid school component of the medicaid program, including rules that establish or specify all of the following: (A) Conditions a board of education of a city, local, or exempted school district, a governing board of an educational service center, governing authority of a community school established u...

...less the department of medicaid for any cost or penalty resulting from a federal or state audit finding that a claim submitted by the provider under section 5162.361 of the Revised Code did not comply with a federal or state requirement applicable to the claim, including a requirement of a medicaid waiver component.

...(A) Subject to division (B) of this section and for the purpose of a medicaid recipient receiving, in accordance with the recipient's individualized education program, physical therapy services, occupational therapy services, speech-language pathology services, or audiology services under the medicaid school component of the medicaid program: (1) A physical therapist is a licensed practitioner of the healing arts fo...

...Any contract the department of medicaid enters into with the department of mental health and addiction services under section 5162.35 of the Revised Code is subject to the approval of the director of budget and management and shall require or specify all of the following: (A) That section 5162.371 of the Revised Code be complied with; (B) How providers will be paid for providing the services; (C) The respons...

...If the department of medicaid enters into a contract with the department of mental health and addiction services under section 5162.35 of the Revised Code, the department of medicaid shall pay the nonfederal share of any medicaid payment to a provider for services under the component, or aspect of the component, the department of mental health and addiction services administers.