Ohio Revised Code Search

...Whoever violates division (B) of section 5160.45 of the Revised Code is guilty of a misdemeanor of the first degree.

...coverage of community behavioral health services beginning July 1, 2017, including revisions that update medicaid billing codes and payment rates for community behavioral health services. (C) "Clean claim" has the same meaning as in 42 C.F.R. 447.45(b). (D) "Community behavioral health services" means both of the following: (1) Alcohol and drug addiction services provided by a community addiction services provi...

...nt, duration, and scope of the medicaid services covered by the medicaid program; (2) The medicaid payment rate for each medicaid service or, in lieu of the rate, the method by which the rate is to be determined for each medicaid service; (3) Procedures for enforcing the rules adopted under this section that provide due process protections, including procedures for corrective action plans for, and imposing financia...

...caid program shall cover all mandatory services. (B) The medicaid program shall cover all of the optional services that state statutes require the medicaid program to cover. (C) The medicaid program may cover any of the optional services to which either of the following applies: (1) State statutes expressly permit the medicaid program to cover the optional service; (2) State statutes do not address whether ...

...ogram shall cover occupational therapy services provided by an occupational therapist licensed under section 4755.08 of the Revised Code. Coverage shall not be limited to services provided in a hospital or nursing facility. Any licensed occupational therapist may enter into a provider agreement with the department of medicaid to provide occupational therapy services under the medicaid program.

...m shall cover evaluation and management services provided by a chiropractor if the chiropractor is licensed to practice chiropractic under Chapter 4734. of the Revised Code. (2) The medicaid director may adopt rules under section 5164.02 of the Revised Code to cover other services provided by a chiropractor under the medicaid program. (3) With respect to the coverage described in this section, all of the followin...

...covered as inpatient care shall include medical, educational, and any other services that are consistent with the inpatient care recommended in the protocols and guidelines developed by national organizations that represent pediatric, obstetric, and nursing professionals. (2) The medicaid program shall cover a physician-directed source of follow-up care or a source of follow-up care directed by an advanced practice...

... The medicaid program shall cover doula services that are provided by a doula if the doula has a valid provider agreement and is certified under section 4723.89 of the Revised Code. Medicaid payments for doula services shall be determined on the basis of each pregnancy, regardless of whether multiple births occur as a result of that pregnancy. (C) Any provider outcome measurements or incentives the department of me...

...donor milk or human milk fortifiers are medically necessary because the infant meets any of the following criteria: (a) The infant has a birth weight less than eighteen hundred grams or body weight below healthy levels. (b) The infant has a gestational age at birth of thirty-four weeks or less. (c) The infant has any congenital or acquired condition for which the health professional determines that the use o...

... any additional screening method deemed medically necessary by a treating health care provider for proper breast cancer screening in accordance with applicable American college of radiology guidelines, including magnetic resonance imaging, ultrasound, or molecular breast imaging. (B) The medicaid program shall cover all of the following: (1) To detect the presence of breast cancer in adult women, screening mammog...

...(A) Except as provided in division (C) of this section, the medicaid program shall cover prescribed, orally administered cancer medications on at least the same basis that it covers intraveneously administered or injected cancer medications. In implementing this section, the department of medicaid shall not institute cost-sharing requirements under section 5162.20 of the Revised Code for prescribed, orally admi...

...(A) As used in this section: (1) "Benzodiazepine" has the same meaning as in section 3719.01 of the Revised Code. (2) "Chronic pain" has the same meaning as in section 4731.052 of the Revised Code. (3) "Hospice care program" and "hospice patient" have the same meanings as in section 3712.01 of the Revised Code. (4) "Opioid analgesic" has the same meaning as in section 3719.01 of the Revised Code. (5) "Prescriber...

... The technology is used only to collect medical and other data from a patient and electronically transmit that data securely to a health care provider in a different location for that provider's examination of the data; (b) The technology has been approved by the United States food and drug administration for remote data acquisition, if required under federal law. (2) For remote fetal nonstress tests, the CPT c...

... to any of the following evidence-based medical necessity criteria: (1) The patient has symptoms that suggest a broad differential diagnosis that would require an evaluation by multiple genetic tests if rapid whole genome sequencing is not performed. (2) The patient's treating health care provider has determined that timely identification of a molecular diagnosis is necessary to guide clinical decision-making and...

...n; (2) All forms of tobacco cessation services recommended by the United States preventive services task force, including individual, group, and telephone counseling and any combination thereof. (B) The department of medicaid shall not impose any of the following conditions with respect to the coverage required by this section: (1) Counseling requirements for tobacco cessation medications; (2) Except as provi...

...ed Code, including any of the following services: (A) Managing drug therapy under a consult agreement pursuant to section 4729.39 of the Revised Code; (B) Administering immunizations in accordance with section 4729.41 of the Revised Code; (C) Administering drugs in accordance with section 4729.45 of the Revised Code.

...ealth professional; (3) Unscheduled, emergency mental health services of a kind ordinarily provided to persons in crisis when rendered by persons supervised by a mental health professional; (4) Assertive community treatment and intensive home-based mental health services. (C) The department of medicaid shall enter into a separate contract with the department of mental health and addiction services under sect...

...cent of the federal poverty line, has a medical need for the service, and meets all other eligibility requirements for the service specified in rules adopted under section 5164.02 of the Revised Code. The rules may not require a medicaid recipient to undergo a level of care determination to be eligible for a state plan home and community-based service.

...aid program may cover tobacco cessation services in addition to the services that must be covered under section 5164.10 of the Revised Code or may exclude coverage of additional tobacco cessation services.

...The medicaid program shall not cover prescribed drugs for treatment of erectile dysfunction.

...s eligible for medicaid case management services. If either department approves, reduces, denies, or terminates a service, that department shall timely notify the medicaid recipient that the recipient may appeal pursuant to section 5160.31 of the Revised Code.

...The department of medicaid shall establish a combination of written and oral methods designed to provide information about healthcheck to all persons eligible for the program or their parents or guardians. The department shall ensure that its methods of providing information are effective. Each entity that distributes or accepts applications for medicaid shall prominently display a notice that complies with t...

...lities, and mental health and addiction services shall participate in the development of the revisions and shall utilize the revised system.

...The department of medicaid shall establish a credentialing program that includes a credentialing committee to review the competence, professional conduct, and quality of care provided by medicaid providers. Any activities performed by the credentialing committee shall be considered activities of a peer review committee of a health care entity and shall be subject to sections 2305.25 to 2305.253 of the Revised Code....

...No person or government entity may participate in the medicaid program as a medicaid provider without a valid provider agreement with the department of medicaid.