Ohio Revised Code Search

...y-based services pursuant to section 5124.60 or 5124.61 of the Revised Code.

...ties shall adopt rules under section 5124.03 of the Revised Code as necessary to implement this section, including rules that do the following: (a) Specify the reasons for which a temporary absence from an ICF/IID makes the absence qualify for payments under this section; (b) Establish conditions under which prior authorization may be obtained for the purpose of division (C) of this section. (2) The rules authoriz...

...Medicaid payments may be made for ICF/IID services provided not later than thirty days after the effective date of an involuntary termination of the ICF/IID that provides the services if the services are provided to a medicaid recipient who is eligible for the services and resided in the ICF/IID before the effective date of the involuntary termination.

...The department of developmental disabilities shall make its best efforts each year to determine ICFs/IID's medicaid payment rates under this chapter in time to pay the rates by August fifteenth of each 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 a...

... and the rules adopted under section 5124.03 of the Revised Code. The provider, group, or association may submit written arguments or other materials that support its position. The provider, group, or association and department shall take actions regarding the rate reconsideration within time frames specified in rules authorized by this section. If the department determines, as a result of the rate reconsideration,...

... report for an ICF/IID under section 5124.107 of the Revised Code and the amended report shows that the provider received a lower medicaid payment rate under the original 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 begin...

...report for the ICF/IID under section 5124.107 of the Revised Code; (2) The department makes a finding based on an audit under section 5124.109 of the Revised Code. (B) The department shall apply the redetermined rate to the periods when the provider received the incorrect rate to determine the amount of the overpayment. The provider shall refund the amount of the overpayment. The department may charge the provide...

... 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 bank prime rate plus four per cent of the last two monthly payments.

...5, "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 federal reserve board.

...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 enter into an agreement under which a deduction required by division (A) of this section is taken in installments from payments the department makes to the provider.

... and interest charged under, section 5124.41 of the Revised Code; (B) Penalties imposed under section 5124.42 of the Revised Code.

...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 5124.42 of the Revised Code or section 5124.523 of the Revised Code.

...fied 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 exiting operator and, if any, the exiting operator's authorized agent; (B) The name of the ICF/IID that is the subject of the written notice; (C) The exiting operator's medicaid provider agreement number for the ICF/IID that is the subject of the written notice; (D) The...

...fied in rules authorized by section 5124.53 of the Revised Code. The written notice shall be provided to the department of developmental disabilities and department of medicaid not later than forty-five days before the effective date of the change of operator if the change of operator does not entail the relocation of residents. The written notice shall be provided to the department of developmental disabiliti...

... 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 operator, a completed application for a provider ...

... 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 department receives, from the exiting operator or ...

...department of medicaid under section 5124.511 or 5124.512 of the Revised Code shall do all of the following: (A) Comply with all applicable federal statutes and regulations; (B) Comply with section 5124.07 of the Revised Code and all other applicable state statutes and rules; (C) Comply with all the terms and conditions of the exiting operator's provider agreement, including all of the following: (1) Any pla...

...ement is entered into under section 5124.511 or 5124.512 of the Revised Code.

...der agreement as provided in section 5124.07 of the Revised Code, rather than section 5124.511 or 5124.512 of the Revised Code, with an entering operator if the entering operator does not agree to a provider agreement that satisfies the requirements of division (C) of section 5124.513 of the Revised Code. The department may not enter into the provider agreement unless the department of health certifies the ICF/...

...ities may adopt rules under section 5124.03 of the Revised Code governing adjustments to the medicaid reimbursement rate for an ICF/IID that undergoes a change of operator. No rate adjustment resulting from a change of operator shall be effective before the effective date of the entering operator's provider agreement. This is the case regardless of whether the provider agreement is entered into under section 5...

...'s provider agreement under section 5124.511, section 5124.512, or, pursuant to section 5124.515, section 5124.07 of the Revised Code.

...t of a written notice under section 5124.50 of the Revised Code of a facility closure or voluntary termination, on receipt of a written notice under section 5124.51 of the Revised Code of a change of operator, or on the effective date of an involuntary termination, the department of developmental disabilities shall estimate the amount of any overpayments made under the medicaid program to the exiting operator,...

...ovided under division (C) of section 5124.52 of the Revised Code that the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program. (B) In the case of a change of operator and subject to division (E) of this section, the following shall apply regarding a withholding under division (A) of this section if the exiting operator or e...

...ious 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 cost report shall include, as applicable, all of the following: (1) The sale price of the ICF/IID; (2) A final depreciation schedule that shows which assets are transferred to the buyer and which assets are not transferred to the buyer; (3) Any othe...

...xiting operator required by section 5124.522 of the Revised Code to file a cost report with the department of developmental disabilities fails to file the cost report in accordance with that section, all payments under the medicaid program for the period the cost report is required to cover are deemed overpayments until the date the department receives the properly completed cost report. The department may imp...