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Section 5163.103 | Presumptive eligibility error rate training.

...(A) As used in this section: (1) "Presumptive eligibility error rate" means the rate at which a qualified entity or qualified provider deems an individual presumptively eligible for medicaid under sections 5163.10 to 5163.102 of the Revised Code when the individual is ineligible for the medicaid program. (2) "Qualified entity" has the same meaning as in section 5163.101 of the Revised Code. (3) "Qualified pr...

Section 5163.20 | Beneficiary of disability trust.

...If a medicaid recipient is the beneficiary of a trust created pursuant to section 5815.28 of the Revised Code, then, notwithstanding any contrary provision of this chapter or of a rule adopted under section 5163.02 of the Revised Code, divisions (C) and (D) of that section shall apply in determining the assets or resources of the recipient, the recipient's estate, the settlor, or the settlor's estate and to cla...

Section 5163.21 | Eligibility determinations for cases involving medicaid programs.

...d supplant or replace medicaid or other public assistance; (b) A provision that prohibits the trustee from making payments that would impact or have an effect on the applicant's or recipient's right, ability, or opportunity to receive medicaid or other public assistance; (c) A provision that attempts to prevent the trust or its corpus or principal from being a resource available to the applicant or recipient. (4) ...

Section 5163.22 | Life insurance policies.

...(A) The general assembly hereby finds that the state has an insurable interest in medicaid recipients because of the state's statutory right to recover from the estate of a recipient state funds used to provide the recipient with medicaid services. (B) As used in this section: (1) "Beneficiary" means the person or entity designated in a life insurance policy to receive the proceeds of the policy on the death...

Section 5163.30 | Disposal of assets under market value after look-back date.

...(A) As used in this section: (1) "Assets" include all of an individual's income and resources and those of the individual's spouse, including any income or resources the individual or spouse is entitled to but does not receive because of action by any of the following: (a) The individual or spouse; (b) A person or government entity, including a court or administrative agency, with legal authority to act in place o...

Section 5163.31 | Real property not homestead after 13-month institutional residence.

...(A) Except as provided by division (A) of this section and for the purpose of determining whether an aged, blind, or disabled individual is eligible for nursing facility services, ICF/IID services, or other medicaid-funded long-term care services, the medicaid director may consider an aged, blind, or disabled individual's real property to not be the individual's homestead or principal place of residence once th...

Section 5163.32 | Equity interest in home exceeds $500,000.

...(A) Except as otherwise provided by this section, no individual shall qualify for nursing facility services or other medicaid-funded long-term care services if the individual's equity interest in the individual's home exceeds five hundred thousand dollars. The medicaid director shall increase this amount effective January 1, 2011, and the first day of each year thereafter, by the percentage increase in the cons...

Section 5163.33 | Deducting personal needs allowance from recipient's income.

...(A) In determining the amount of income that a medicaid recipient must apply monthly toward payment of the cost of care in a nursing facility or ICF/IID, a county department of job and family services shall deduct from the recipient's monthly income a monthly personal needs allowance in accordance with the "Social Security Act," section 1902(q), 42 U.S.C. 1396a(q). (B) In the case of a resident of a nursing facility...

Section 5163.40 | Healthy start component.

...ication form for the component to each public or private entity that serves as a women, infants, and children clinic or as a child and family health clinic and to each administrative body for such clinics and train employees of each such clinic or administrative body to provide applicants assistance in completing the form; (b) In cooperation with the department of health, develop arrangements under which emplo...

Section 5163.45 | Confinement of medicaid recipient in correctional facility.

...(A)(1) As used in this section, subject to division (A)(2) of this section, "state or local correctional facility" means any of the following: (a) A "state correctional institution," as defined in section 2967.01 of the Revised Code; (b) A "local correctional facility," as defined in section 2903.13 of the Revised Code; (c) A correctional facility that is privately operated and managed pursuant to section 9....

Section 5164.01 | Definitions.

...As used in this chapter: (A) "Adjudication" has the same meaning as in section 119.01 of the Revised Code. (B) "Behavioral health redesign" means revisions to the medicaid program's 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...

Section 5164.02 | Rules to implement chapter.

...(A) The medicaid director shall adopt rules as necessary to implement this chapter. The rules shall be adopted in accordance with Chapter 119. of the Revised Code. (B) The rules shall establish all of the following: (1) The amount, 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 ra...

Section 5164.03 | Mandatory and optional services.

...(A) The medicaid 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 addr...

Section 5164.06 | Medicaid coverage of occupational therapy services.

...The medicaid program 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.

Section 5164.061 | Chiropractic services.

...(A) As used in this section: (1) "Prescriber" has the same meaning as in section 4729.01 of the Revised Code, but does not include a dentist, optometrist, or veterinarian. (2) "Prior authorization requirement" means any practice in which coverage of a health care service, device, or drug is dependent upon a recipient or health care practitioner obtaining approval from the medicaid program prior to the service, de...

Section 5164.07 | Coverage of inpatient care and follow-up care for a mother and her newborn.

...(A) The medicaid program shall include coverage of inpatient care and follow-up care for a mother and her newborn as follows: (1) The medicaid program shall cover a minimum of forty-eight hours of inpatient care following a normal vaginal delivery and a minimum of ninety-six hours of inpatient care following a cesarean delivery. Services covered as inpatient care shall include medical, educational, and any other ser...

Section 5164.071 | Doula program.

...(A) As used in this section, "doula" has the same meaning as in section 4723.89 of the Revised Code. (B) 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...

Section 5164.072 | Coverage of donor breast milk and fortifiers.

...(A) As used in this section, "licensed health professional" means the following: (1) A physician authorized under Chapter 4731. of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery; (2) An advanced practice registered nurse who holds a current, valid license issued under Chapter 4723. of the Revised Code that authorizes the practice of nursing as an advanced practice register...

Section 5164.08 | Breast cancer and cervical cancer screening.

...(A) As used in this section: (1) "Screening mammography" means a radiologic examination utilized to detect unsuspected breast cancer at an early stage in asymptomatic women and includes the x-ray examination of the breast using equipment that is dedicated specifically for mammography, including the x-ray tube, filter, compression device, screens, film, and cassettes, and that has an average radiation exposure deli...

Section 5164.09 | Equivalent coverage for orally and intravenously administered cancer medications.

...(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...

Section 5164.091 | Coverage for opioid analgesics.

...(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...

Section 5164.092 | Coverage of remote ultrasounds and fetal nonstress tests.

...(A) Except as provided in division (B) of this section, the medicaid program shall cover remote ultrasound procedures and remote fetal nonstress tests, utilizing established current procedural terminology codes (CPT codes) for those procedures for when the patient is in a residence or other off-site location from the patient's medicaid provider. (B) The coverage under division (A) of this section applies only unde...

Section 5164.10 | Coverage of tobacco cessation medications and services.

...ration recommended in the United States public health service clinical practice guidelines on treating tobacco use and dependence; (b) Services associated with more than two attempts to quit using tobacco within a twelve-month period. (C) The director of health shall adopt rules in accordance with Chapter 119. of the Revised Code that establish standards and procedures for approving the forms of tobacco cessatio...

Section 5164.14 | Medicaid coverage for health care service provided by pharmacist.

...The medicaid program may cover a health care service that a pharmacist provides to a medicaid recipient in accordance with Chapter 4729. of the Revised 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 ...

Section 5164.15 | Mental health services.

...(A) As used in this section: (1) "Community mental health services provider or facility" means a community mental health services provider or facility that has its community mental health services certified by the department of mental health and addiction services under section 5119.36 of the Revised Code or by the department of children and youth under section 5103.03 of the Revised Code. (2) "Mental health pr...

Section 151.10 | Issuing obligations to pay costs of research and development projects.

...roperty therefore; and (e) Support for public and private institutions of higher education, research organizations or institutions, and private sector entities. (2) "Obligations" means obligations as defined in section 151.01 of the Revised Code issued to pay costs of projects for research and development purposes as referred to in division (A)(2) of Section 2p of Article VIII, Ohio Constitution. (3) "Project" mea...

Section 151.11 | Issuing obligations to pay costs of sites and facilities.

...(A) As used in this section: (1) "Costs of sites and facilities" includes related direct administrative expenses and allocable portions of the direct costs of those projects. "Costs of sites and facilities" includes "allowable costs" as defined in section 122.085 of the Revised Code. (2) "Obligations" means obligations as defined in section 151.01 of the Revised Code issued to pay costs of sites and faciliti...

Section 151.40 | Issuing obligations for paying costs of revitalization projects.

...(A) As used in this section: (1) "Bond proceedings" includes any trust agreements, and any amendments or supplements to them, as authorized by this section. (2) "Costs of revitalization projects" includes related direct administrative expenses and allocable portions of the direct costs of those projects of the department of development or the environmental protection agency. (3) "Issuing authority" means the...

Section 153.01 | Architect must submit accurate plans, estimates, bills of materials, and details to scale.

...in part by the state or in or upon the public works of the state that is administered by the Ohio facilities construction commission or by any other state officer or state agency authorized by law to administer a project, including an educational institution listed in section 3345.50 of the Revised Code, is to be erected or constructed, whenever additions, alterations, or structural or other improvements are t...

Section 153.011 | Using domestic steel products in state supported projects.

...teel products for use in contracts for public bridge projects. The executive director of the Ohio facilities construction commission may waive the requirements of division (A) of this section if the executive director determines that either division (A) or (B) of section 5525.21 of the Revised Code is true in connection with a public bridge project. The executive director shall issue this determination in writ...

Section 153.012 | Preference to contractors having principal place of business in Ohio.

...on, repair, painting or decoration of a public improvement, including any highway improvement, made by the state or in whole or in part supported by the state, except for a contract for products produced or mined in Ohio or for a contract financed in whole or in part by contributions or loans from any agency of the United States government, preference shall be given to contractors having their principle place of busi...

Section 153.013 | Capitol square review and advisory board - indefinite delivery indefinite quantity contract.

...(A) As used in this section, "indefinite delivery indefinite quantity contract" means a contract for an indefinite quantity, within stated limits, of supplies or services that will be delivered by the awarded bidder over a defined contract period. (B) The executive director of the capitol square review and advisory board, with the approval of the board, may advertise and seek bids for, and may award, an indefinite ...

Section 153.02 | Debarment of contractor from contract awards.

...r a contractor from contract awards for public improvements as referred to in section 153.01 of the Revised Code or for projects as defined in section 3318.01 of the Revised Code, upon proof that the contractor has done any of the following: (1) Defaulted on a contract requiring the execution of a takeover agreement as set forth in division (B) of section 153.17 of the Revised Code; (2) Knowingly failed during th...

Section 153.03 | Contracts to require drug-free workplace program.

...mentality that is authorized to award a public improvement contract. (2) "Bidder" means a person who submits a bid to a contracting authority to perform work under a public improvement contract. (3) "Contractor" means any person with whom a contracting authority has entered into a public improvement contract to provide labor for a public improvement and includes a construction manager at risk and a design-bui...

Section 153.031 | RC 153.03 requirements limited to state improvements.

...constructing, altering, or repairing of public improvements of the state and to be of assistance in ensuring that such public improvements are constructed, altered, or repaired in a manner that protects the safety of the citizens of this state.

Section 153.04 | Forms for providing bidding information - life-cycle costs.

...The plans, details, bills of material, specifications of work, estimates of cost in detail and in the aggregate, life-cycle cost analysis, form of bid, bid guaranty, and other data that may be required shall be prepared on such material and in such manner and form as are prescribed by the Ohio facilities construction commission. The life-cycle costs shall be a primary consideration in the selection of a design....

Section 153.05 | Actions to enforce bond.

...The bond required by section 153.08 of the Revised Code may be enforced against the person executing such bond, by any claimant for labor or material, and suit may be brought on such bond in the name of the state on relation of the claimant within one year from the date of delivering or furnishing such labor or material, in the court of common pleas of the county wherein such labor or material was furnished or delive...

Section 153.06 | Form of bids.

... 153.01 of the Revised Code shall give public notice of the time and place when and where bids will be received for performing the labor and furnishing the materials of such construction, improvement, alteration, addition, or installation, and a contract awarded, except for materials manufactured by the state or labor supplied by a county department of job and family services that may enter into the same. The f...

Section 153.07 | Publishing notice of bids.

...ties construction commission, the last publication to be at least eight days preceding the day for opening the bids, and in such form and with such phraseology as the commission orders. Copies of the plans, details, estimates of cost, and specifications shall be open to public inspection at all business hours between the day of the first publication and the day for opening the bids, at the office of the commis...

Section 153.08 | Opening bids and awarding contract.

...ised Code shall open the bids and shall publicly, with the assistance of the architect or engineer, immediately proceed to tabulate the bids. For a bid filed electronically, the public bid opening may be broadcast by electronic means pursuant to rules established by the Ohio facilities construction commission. A bid shall be invalid and not considered unless a bid guaranty meeting the requirements of section 153.54 o...

Section 153.09 | New proposals when necessary - change in work or materials.

...If in the opinion of the owner referred to in section 153.01 of the Revised Code, the award of a contract to the lowest responsive and responsible bidder is not in the best interests of the state, the owner may accept another bid so opened or reject all bids, and advertise for other bids. Such advertisement shall be for such time, in such form, and in such newspaper as the Ohio facilities construction commissio...

Section 153.10 | No change in plans without approval of owner.

...After the plans, bills of material, specifications of work, estimates of cost in detail and in the aggregate, life-cycle cost analysis, form of bid, bid guaranty, and other data that may be required are approved and filed with the owner as defined in section 153.01 of the Revised Code, no change of plans, details, bills of material, or specifications shall be made or allowed unless the same are approved by the owner ...

Section 153.11 | Change of plans becomes part of original contract.

...Whenever the change referred to in section 153.10 of the Revised Code is approved by the owner as defined in section 153.01 of the Revised Code, accepted in writing by the contractor, and filed, the same shall be considered as being a part of the original contract, and the bond theretofore executed shall be increased or decreased accordingly to include and cover the change in the contract.

Section 153.12 | Awarding and executing contract.

...n, repair, painting, or decoration of a public improvement made by the state, or any county, township, municipal corporation, school district, or other political subdivision, or any public board, commission, authority, instrumentality, or special purpose district of or in the state or a political subdivision or that is authorized by state law, the award, and execution of the contract, shall be made within sixty days ...

Section 153.13 | Estimates of labor and materials - funds in escrow account.

...At the time named in the contract for payment to the person with whom it is made, the owner referred to in section 153.01 or 153.12 of the Revised Code shall approve a full, accurate, and detailed estimate of the various kinds of labor performed and material furnished under the contract, with the amount due for each kind of labor and material and the materials and amount due in the aggregate, which estimate shall be ...

Section 153.14 | Estimates to be filed with executive director - payment on materials delivered - payment procedure.

...n of those projects, improvements, and public buildings over which the Ohio facilities construction commission has general supervision pursuant to section 123.21 of the Revised Code, the estimates referred to in section 153.13 of the Revised Code shall be filed with the executive director by the owner referred to in section 153.01 or 153.12 of the Revised Code. Upon completion of a project referred to in secti...

Section 153.15 | Assessment of asbestos hazard.

...(A) Whenever an asbestos hazard abatement activity is being performed in a building or structure supported in whole or in part by the state, an asbestos hazard evaluation specialist certified under Chapter 3710. of the Revised Code shall assess the hazard and determine appropriate response actions. Enclosure or encapsulation, rather than removal, shall be implemented if the asbestos hazard evaluation specialist deter...

Section 153.16 | Policy and procedure guidelines for contract documents in conjunction with administration of public works contracts.

...conjunction with the administration of public works contracts that the state or any institution supported in whole or in part by the state enters into for any project subject to sections 153.01 to 153.11 of the Revised Code. (B) Notwithstanding any contract provision to the contrary, any claim submitted under a public works contract that the state or any institution supported in whole or in part by the state ...

Section 153.17 | Requisition upon contractor for additional specific force or materials.

...(A) When in the opinion of the owner referred to in section 153.01 of the Revised Code, the work under any contract made under any law of the state is neglected by the contractor or such work is not prosecuted with the diligence and force specified or intended in the contract, such owner may make requisition upon the contractor for such additional specific force or materials to be brought into the work under such con...

Section 153.18 | Certification of additional force or materials.

...The owner referred to in section 153.01 of the Revised Code shall make separate estimates of all additional force or materials employed or supplied as provided by section 153.17 of the Revised Code, and payment shall be provided for by the director of budget and management. The amount so paid shall be charged against the contractor and be deducted from his next or any subsequent estimate. The amount or any part there...