Ohio Revised Code Search

...e "Social Security Act," section 1927, 42 U.S.C. 1396r-8; (3) The federal share of all supplemental rebates paid by drug manufacturers to the department of medicaid in accordance with the supplemental drug rebate program established under section 5164.755 of the Revised Code; (4) Except as otherwise provided by statute or as authorized by the controlling board, the federal share of all other medicaid-related ...

...tion 1923 of the "Social Security Act," 42 U.S.C. 1396r-4, under the medicaid program to state mental health hospitals maintained and operated by the department of mental health and addiction services under division (A) of section 5119.14 of the Revised Code; (3) Revenues the department of medicaid receives from another state agency for medicaid services pursuant to an interagency agreement; (4) The money the d...

...There is created in the state treasury the health care special activities fund. The department of medicaid shall deposit all funds it receives pursuant to the administration of the medicaid program into the fund, other than any such funds that are required by law to be deposited into another fund. The department shall use the money in the fund to pay for expenses related to the services provided under, and the ...

...nd family services under section 5101.074 of the Revised Code also shall be deposited into the refunds and reconciliation fund. Money in the refunds and reconciliation fund, including money transferred from the department of job and family services, shall be transferred to the appropriate fund once the appropriate fund is identified or shall be transferred to another government entity, as appropriate.

...g interest, collected under section 173.42 of the Revised Code; (3) The portions of civil money penalties and corresponding interest that are disbursed on or after July 1, 2017, to the department of medicaid pursuant to 42 C.F.R. 488.845. (B)(1) Money deposited into the fund pursuant to divisions (A)(1) and (2) of this section shall be used for all of the following: (a) Protection of the health or property of resi...

...ennium, as determined under section 103.412 of the Revised Code. (2) Achieve the limit in the growth of the per member per month cost of the medicaid program under division (B)(1) of this section by doing all of the following: (a) Improving the physical and mental health of medicaid recipients; (b) Providing for medicaid recipients to receive medicaid services in the most cost-effective and sustainable manne...

...The medicaid director shall implement within the medicaid program systems that do both of the following: (A) Improve the health of medicaid recipients through the use of population health measures; (B) Reduce health disparities, including, but not limited to, those within racial and ethnic populations.

...ocial determinants of health, including employment, housing, transportation, food, interpersonal safety, and toxic stress.

...(A) The Department of Medicaid may establish and administer a program to provide dental services to pregnant Medicaid recipients. If the program is established, all of the following shall apply: (1) Medicaid recipients who are members of the group described in section 5163.06 of the Revised Code shall be eligible to receive two dental cleanings per year. (2) The Department shall give priority to those Medicaid r...

...The medicaid director shall provide, to a veteran who has submitted an application for the medicaid program, information about the county veterans service office that can assist with investigating and applying for benefits through the United States department of veterans affairs. As used in this section, "veteran" has the same meaning as in section 5901.01 of the Revised Code.

...r certified under Chapter 3721., 3727., 4715., 4725., 4731., 4732., 4734., 4747., 4753., 4755., 4757., or 4779. of the Revised Code shall provide in writing, before products, services, or procedures are provided, a reasonable, good-faith estimate of all of the following for the provider's non-emergency products, services, or procedures: (1) The amount the provider will charge the patient or the consumer's health pla...

...caid program as provided in section 103.41 of the Revised Code of the increase.

...er relative" has the same meaning as in 42 C.F.R. 435.4 as that regulation is amended effective January 1, 2014. "Expansion eligibility group" means the medicaid eligibility group described in section 1902(a)(10)(A)(i)(VIII) of the "Social Security Act," 42 U.S.C. 1396a(a)(10)(A)(i)(VIII). "Federal financial participation" has the same meaning as in section 5160.01 of the Revised Code. "Federal poverty line" has t...

...The medicaid director shall adopt rules as necessary to implement this chapter. The rules shall establish eligibility requirements for the medicaid program. The rules may establish requirements for applying for medicaid and determining and verifying eligibility for medicaid. The rules shall be adopted in accordance with section 111.15 of the Revised Code. ( Notwithstanding any provision of state law, includi...

...(A) The medicaid program shall cover all mandatory eligibility groups. (B) The medicaid program shall cover all of the optional eligibility groups that state statutes require the medicaid program to cover. (C) The medicaid program may cover any of the optional eligibility groups to which either of the following applies: (1) State statutes expressly permit the medicaid program to cover the optional eligibility g...

...nsferred in accordance with section 131.44 of the Revised Code. (2) If the change to the federal medical assistance percentage described in division (A) of this section occurs during the first year of a fiscal biennium, the state share amount certified under division (A)(2) of this section shall be multiplied by twelve for the second year of the fiscal biennium. The amount calculated under this division shall remai...

...ii)(VIII) of the "Social Security Act," 42 U.S.C. 1396a(a)(10)(A)(ii)(VIII); (B) Subject to section 5163.061 of the Revised Code, the group consisting of women during pregnancy and the maximum postpartum period permitted under 42 U.S.C. 1396a(e) beginning on the last day of the pregnancy, infants, and children who are specified in section 1902(a)(10)(A)(ii)(IX) of the "Social Security Act," 42 U.S.C. 1396a(a)(10)(...

...The income eligibility threshold is two hundred per cent of the federal poverty line for women during pregnancy and the postpartum period beginning on the last day of the pregnancy who are covered by the medicaid program under division (B) of section 5163.06 of the Revised Code.

...ii)(XIII) of the "Social Security Act," 42 U.S.C. 1396a(a)(10)(A)(ii)(XIII). By requiring the medicaid program to provide coverage to the optional eligibility group consisting of employed individuals with disabilities under division (C) of section 5163.06 of the Revised Code, it is the intent of the general assembly to establish medicaid coverage for employed individuals with disabilities who are sixty-five years ...

... Security Act," section 1931(b)(2)(C), 42 U.S.C. 1396u-1(b)(2)(C), to set the income eligibility threshold at ninety per cent of the federal poverty line for parents and caretaker relatives who are covered by the medicaid program under that section of the "Social Security Act."

...Social Security Act," section 1905(v), 42 U.S.C. 1396d(v). "Family" means an applicant or participant and the spouse and dependent children of the applicant or participant. If an applicant or participant is under eighteen years of age, "family" also means the parents of the applicant or participant. "Health insurance" has the meaning established by rules authorized by section 5163.098 of the Revised Code. "In...

...ection 5163.092 of the Revised Code; (4) That the individual's income, less amounts disregarded pursuant to section 5163.093 of the Revised Code, does not exceed two hundred fifty per cent of the federal poverty line; (5) That the individual meets the additional eligibility requirements for the medicaid buy-in for workers with disabilities program established in rules authorized by section 5163.098 of the Revised...

...(A) Except as provided in division (B) of this section, the maximum value of resources, less amounts disregarded pursuant to rules authorized by section 5163.098 of the Revised Code, that an individual may have without the individual exceeding the resource eligibility limit for the medicaid buy-in for workers with disabilities program shall not exceed ten thousand dollars. (B) Each calendar year, the medicaid...

...For the purpose of determining whether an individual is within the income eligibility limit for the medicaid buy-in for workers with disabilities program, all of the following apply: (A) Twenty thousand dollars of the individual's earned income shall be disregarded. (B) No amount that the individual's employer pays to obtain health insurance for one or more members of the individual's family shall be treated as ...

...An individual shall not be required to pay a premium as a condition of qualifying for the medicaid buy-in for workers with disabilities program.