Ohio Revised Code Search

...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.

...aid services; (2) Violates section 5164.09 or 5164.10 of the Revised Code. (B)(1) No provider shall refuse to provide a service to a medicaid recipient who is unable to pay a required copayment for the service. (2) Division (B)(1) of this section shall not be considered to do either of the following with regard to a medicaid recipient who is unable to pay a required copayment: (a) Relieve the medicaid recipie...

...mined by the department of medicaid. (4) "Qualified state long-term care insurance partnership program" means the program established under section 5164.86 of the Revised Code. (5) "Time of death" shall not be construed to mean a time after which a legal title or interest in real or personal property or other asset may pass by survivorship or other operation of law due to the death of the decedent or terminat...

...r the "Social Security Act," section 1614, 42 U.S.C. 1382c, considered to be blind or disabled; (3) The recipient's sibling who has an equity interest in the home and resided in the home for at least one year immediately before the date of the recipient's admission to the institution. (D) The medicaid director or a person designated by the director shall sign a certificate to effectuate a lien required to be i...

...The department of medicaid shall certify amounts due under the medicaid estate recovery program instituted under section 5162.21 of the Revised Code to the attorney general pursuant to section 131.02 of the Revised Code. The attorney general may enter into a contract with any person or government entity to collect the amounts due on behalf of the attorney general. The attorney general, in entering into a cont...

...ty or home manages for the resident. (4) "Residential facility" means a residential facility licensed under section 5119.34 of the Revised Code that provides accommodations, supervision, and personal care services for three to sixteen unrelated adults. (B) Except as provided in divisions (C) and (D) of this section, the owner or operator of a home or residential facility shall transfer to the department of me...

...(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...

...s, 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 the costs of such services but has not used ...

...or medicare and medicaid services under 42 C.F.R. 438.6(c). (2) "Preprint" means a form created by the United States centers for medicare and medicaid services to request approval of a state directed payment program, as required under 42 C.F.R. 438.6(c). (B)(1) Except as provided in division (B)(2) or (3) of this section, the medicaid director shall comply with this section for all new and existing state directed...

...The department of medicaid shall prepare and submit quarterly reports to the legislative service commission and the chairpersons of the standing committees in the house of representatives and the senate with jurisdiction over medicaid regarding any new state directed payment programs established under section 5162.25 of the Revised Code.

...(A) The medicaid director shall create a medicaid administrative claiming program under which federal financial participation 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 ...

...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...

...he department, subject to section 5162.40 of the Revised Code.

...The department of medicaid may enter into contracts with one or more other state agencies or political subdivisions to have the state agency or political subdivision administer one or more components of the medicaid program, or one or more aspects of a component, under the department's supervision. A state agency or political subdivision that enters into such a contract shall comply with the terms of the contra...

...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 qualified medicaid school provider participating in the medicaid school component of the medicaid program may submit a claim to the department of medicaid for federal financial participation for providing, in schools, services covered by the medicaid school component to medicaid recipients who are eligible for the services. No qualified medicaid school provider may submit such a claim before the provider incurs the...

...The department of medicaid shall seek federal financial participation for each claim a qualified medicaid school provider properly submits to the department under section 5162.361 of the Revised Code. The department shall disburse the federal financial participation the department receives from the federal government for such a claim to the qualified medicaid school provider that submitted the claim. The depart...

...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...

...ity school established under Chapter 3314. of the Revised Code,, and Ohio deaf and blind education services must meet to participate in the component; (B) Services the component covers; (C) Payment rates for the services the component covers. The rules shall be adopted in accordance with Chapter 119. of the Revised Code.

...(A) A qualified medicaid school provider is solely responsible for timely repaying any overpayment that the provider receives under the medicaid school component of the medicaid program and that is discovered by a federal or state audit. This is the case regardless of whether the audit's finding identifies the provider, department of medicaid, or department of education and workforce as being responsible for the over...

... of the healing arts for the purpose of 42 C.F.R. 440.110(a)(1) and may make a referral for physical therapy services for the recipient. (2) An occupational therapist is a licensed practitioner of the healing arts for the purpose of 42 C.F.R. 440.110(b)(1) and may make a referral for occupational therapy services for the recipient. (3) A speech-language pathologist is a licensed practitioner of the healing arts for...

...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 responsib...

...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.

...(A) If a state agency or political subdivision administers one or more components of the medicaid program or administers one or more aspects of such a component, the department of medicaid may retain or collect not more than ten per cent of the federal financial participation the state agency or political subdivision obtains through an approved, administrative claim regarding the component or aspect of the component....

... the upper payment limit established by 42 C.F.R. 447.272. If the department retains or collects a percentage of that federal financial participation, the medicaid director shall adopt a rule under section 5162.02 of the Revised Code specifying the percentage the department is to retain or collect. All amounts the department retains or collects under this section shall be deposited into the health care/medicaid suppo...