Ohio Revised Code Search

... rate to any resident who is not eligible for medicaid.

...pient is discharged from the ICF/IID, unless the recipient is discharged from the ICF/IID because all of the beds in the ICF/IID are converted from providing ICF/IID services to providing home and community-based services pursuant to section 5124.60 or 5124.61 of the Revised Code.

...ts under this section as specified in rules authorized by this section; (2) The resident's plan of care provides for the absence; (3) Federal financial participation is available for the payments. (C) The maximum period during which medicaid payments may be made to reserve a bed shall not exceed the maximum period specified in federal regulations and shall not be more than thirty days during any calendar year for ...

...d to a medicaid recipient who is eligible for the services and resided in the ICF/IID before the effective date of the involuntary termination.

... fiscal year. If the department is unable to calculate the rates so that they can be paid by that date, the department shall pay each provider the rate calculated for the provider's ICFs/IID under those sections at the end of the previous fiscal year. If the department also is unable to calculate the rates to make the payments due by the fifteenth day of September and the fifteenth day of October, the departmen...

...xisting ICF/IID or replaced at the same site, the department, through the rate reconsideration process, may proportionately increase the ICF/IID's per medicaid day capital component rate determined under that section to account for the costs of the beds that are added or replaced. (2) If the department grants an increase under division (D)(1) of this section, the increase shall go into effect one month after the fi...

... cost report than the provider was entitled to receive, the department of developmental disabilities shall adjust the provider's rate for the ICF/IID prospectively to reflect the corrected information. The department shall pay the adjusted rate beginning two months after the first day of the month after the provider files the amended cost report.

... be not greater than one and one-half times the current average bank prime rate. (2) If the overpayment resulted from costs reported for a subsequent calendar year: (a) The interest shall be not greater than two times the current average bank prime rate if the overpayment was not more than one per cent of the total medicaid payments to the provider for the fiscal year for which the incorrect information was used ...

...year for which the costs were used to determine a rate. (B) If an exiting operator or owner fails to provide notice of a facility closure or voluntary termination as required by section 5124.50 of the Revised Code, or an exiting operator or owner and entering operator fail to provide notice of a change of operator as required by section 5124.51 of the Revised Code, a fine of not more than the current average b...

...ge bank prime rate using statistical release H.15, "selected interest rates," a weekly publication of the federal reserve board, or any successor publication. If statistical release H.15, or its successor, ceases to contain the bank prime rate information or ceases to be published, the department shall request a written statement of the average bank prime rate from the federal reserve bank of Cleveland or the ...

...uct the following from the next available medicaid payment the department makes to an ICF/IID provider who continues to participate in medicaid: (1) Any amount the provider is required to refund, and any interest charged, under section 5124.41 of the Revised Code; (2) The amount of any penalty imposed on the provider under section 5124.42 of the Revised Code. (B) The department and an ICF/IID provider may en...

... in the general revenue fund amounts collected from the following: (A) Refunds required by, and interest charged under, section 5124.41 of the Revised Code; (B) Penalties imposed under section 5124.42 of the Revised Code.

...All of the following are subject to an adjudication conducted in accordance with Chapter 119. of the Revised Code: (A) Any audit disallowance that the department of developmental disabilities makes as the result of an audit under section 5124.109 of the Revised Code; (B) Any medicaid payment deemed an overpayment under section 5124.523 of the Revised Code; (C) Any penalty the department imposes under section 51...

...voluntary termination not less than ninety days before the effective date of the facility closure or voluntary termination. The written notice shall be provided to the department of developmental disabilities and department of medicaid in accordance with the method specified in rules authorized by section 5124.53 of the Revised Code. The written notice shall include all of the following: (A) The name of the e...

...nner in which the entering operator becomes the ICF/IID's operator, including through sale, lease, merger, or other action; (7) If the manner in which the entering operator becomes the ICF/IID's operator involves more than one step, a description of each step; (8) Written authorization from the exiting operator or owner and entering operator for the department of medicaid to process a provider agreement for t...

... The department receives a properly completed written notice required by section 5124.51 of the Revised Code on or before the date required by that section. (B) The department receives both of the following in accordance with the method specified in rules authorized by section 5124.53 of the Revised Code and not later than ten days after the effective date of the change of operator: (1) From the entering opera...

... The department receives a properly completed written notice required by section 5124.51 of the Revised Code. (2) The department receives, from the entering operator and in accordance with the method specified in rules authorized by section 5124.53 of the Revised Code, a completed application for a provider agreement and all other forms and documents specified in rules adopted under that section. (3) The depar...

...ion; (2) Compliance with health and safety standards; (3) Compliance with the ownership and financial interest disclosure requirements of 42 C.F.R. 455.104, 455.105, and 1002.3; (4) Compliance with the civil rights requirements of 45 C.F.R. parts 80, 84, and 90; (5) Compliance with additional requirements imposed by the department; (6) Any sanctions relating to remedies for violation of the provider agreemen...

...In the case of a change of operator, the exiting operator shall be considered to be the operator of the ICF/IID for purposes of the medicaid program, including medicaid payments, until the effective date of the entering operator's provider agreement if the provider agreement is entered into under section 5124.511 or 5124.512 of the Revised Code.

...not enter into the provider agreement unless the department of health certifies the ICF/IID under Title XIX. The effective date of the provider agreement shall not precede any of the following: (A) The date that the department of health certifies the ICF/IID; (B) The effective date of the change of operator; (C) The date the requirement of section 5124.51 of the Revised Code is satisfied.

...ment. This is the case regardless of whether the provider agreement is entered into under section 5124.511, section 5124.512, or, pursuant to section 5124.515, section 5124.07 of the Revised Code.

...rtment of developmental disabilities' determination that a change of operator has or has not occurred for purposes of licensure under section 5123.19 of the Revised Code shall not affect either of the following: (A) A determination by the department of developmental disabilities or department of medicaid of whether or when a change of operator occurs; (B) The department of medicaid's determination of the eff...

...ental disabilities shall establish in rules authorized by section 5124.53 of the Revised Code. The methodology shall provide for estimating all of the following that the department determines are applicable: (1) Refunds due the department under section 5124.41 of the Revised Code; (2) Interest owed to the department and United States centers for medicare and medicaid services; (3) Final civil monetary and oth...

... be paid into the state treasury to the credit of the attorney general claims fund created under section 109.081 of the Revised Code.

...ilities a cost report not later than ninety days after the last day the exiting operator's provider agreement is in effect. The cost report shall cover the period that begins with the day after the last day covered by the operator's most recent previous cost report filed under section 5124.10 or 5124.101 of the Revised Code and ends on the last day the exiting operator's provider agreement is in effect. The cos...