Ohio Revised Code Search
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Section 5162.40 | Retaining or collecting percentage of federal financial participation.
...(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.... |
Section 5162.41 | Retaining or collecting percentage of supplemental payment.
... 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... |
Section 5162.50 | Health care-federal fund.
...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 ... |
Section 5162.52 | Health care/medicaid support and recoveries fund.
...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 dep... |
Section 5162.56 | Health care special activities fund.
...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 ... |
Section 5162.65 | Refunds and reconciliation fund.
...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. |
Section 5162.66 | Residents protection fund.
...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... |
Section 5162.70 | Reforms to medicaid program.
...t committee contracts under section 103.414 of the Revised Code if the committee agrees with the actuary's projected medical inflation rate for that fiscal biennium; (b) The different projected medical inflation rate for a fiscal biennium determined by the joint medicaid oversight committee under section 103.414 of the Revised Code if the committee disagrees with the projected medical inflation rate determined for... |
Section 5162.71 | Implementation of systems to improve health and reduce health disparities.
...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. |
Section 5162.72 | Strategies to address social determinants of health.
...ocial determinants of health, including employment, housing, transportation, food, interpersonal safety, and toxic stress. |
Section 5162.73 | Dental services for pregnant Medicaid recipients.
...(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... |
Section 5162.75 | Notification of veteran services.
...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. |
Section 5162.80 | Good faith estimates for charges and payments.
...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... |
Section 5162.82 | Payment rate increase report to JMOC.
...Before making any payment rate increases greater than ten per cent under the medicaid program, the medicaid director shall notify the joint medicaid oversight committee of the increase and be available to testify before the joint medicaid oversight committee regarding the increase. |
Section 5163.01 | Definitions.
...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... |
Section 5163.02 | Rules establishing eligibility requirements for medicaid.
...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... |
Section 5163.03 | Medicaid coverage.
...(A) Subject to section 5163.05 of the Revised Code, 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 medicai... |
Section 5163.05 | Eligibility requirements for aged, blind, and disabled.
..."Social Security Act," section 1902(f), 42 U.S.C. 1396a(f). |
Section 5163.06 | Optional eligibility groups.
...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)(... |
Section 5163.061 | Income eligibility threshold for pregnant women.
...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. |
Section 5163.063 | Medicaid coverage of employed individuals with a disability.
...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 ... |
Section 5163.07 | Income eligibility threshold for parents and caretaker relatives.
... 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." |
Section 5163.09 | Medicaid buy-in for workers with disabilities program.
...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... |
Section 5163.091 | Qualifications for program.
...section 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 Rev... |
Section 5163.092 | Resource eligibility limit - annual adjustment.
...(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... |