Ohio Revised Code Search
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Section 5155.261 | Lien in lieu of taking property.
... recipient and spouse, and such other information as the board of county commissioners requires, shall be entered upon a certificate, signed by such recipient and his or her spouse, the form of which shall be prescribed by the board of county commissioners. When the certificate describes real estate owned by such recipient or spouse, the board of county commissioners shall file for recording and indexing a certificat... |
Section 5155.31 | Closing of home - subsequent care.
...or a longer period than five years. The form of any lease shall be approved by the prosecuting attorney. |
Section 5155.34 | District homes.
...mmissioners of two or more counties may form themselves into a joint board of county commissioners for the purpose of establishing a "district home." For such purpose a joint board of county commissioners may use a county home site and buildings already established in one such county, or, it may purchase a new site and erect suitable buildings thereon, provided existing county homes in such counties, other than the o... |
Section 5160.34 | Medical assistance programs with prior authorization requirements.
...o the service, device, or drug being performed, received, or prescribed, as applicable. "Prior authorization" includes prospective or utilization review procedures conducted prior to providing a health care service, device, or drug. (5) "Urgent care services" means a medical care or other service for a condition where application of the timeframe for making routine or non-life threatening care determinations is eith... |
Section 5160.40 | Third-party duties; medicaid managed care organizations.
...ate of submission of the claim, type or format of the claim form, or a failure by the medical assistance recipient who is the subject of the claim to present proper documentation of coverage at the time of service, if both of the following have occurred: (a) The claim was submitted by the department not later than six years after the date of the provision of the medical item or service. (b) An action by the dep... |
Section 5160.45 | Disclosure of medical assistance information.
...45 to 5160.481 of the Revised Code, "information" means all of the following: (1) Records, as defined in section 149.011 of the Revised Code; (2) Any other documents in any format; (3) Data derived from records and documents that are generated, acquired, or maintained by the department of medicaid, a county department of job and family services, or an entity performing duties on behalf of the department or a... |
Section 5162.07 | Federal approval for permissive components not required.
...proval shall be sought in the following forms as appropriate: (A) The medicaid state plan; (B) Amendments to the medicaid state plan; (C) Federal medicaid waivers; (D) Amendments to federal medicaid waivers; (E) Other types of federal approval, including demonstration grants. |
Section 5162.35 | Contracts for administration of components.
...act with a state agency shall be in the form of an interagency agreement. A state agency or political subdivision that enters into a contract with the department under this section shall reimburse the department for the nonfederal share of the cost to the department of performing, or contracting for the performance of, a fiscal audit of the component of the medicaid program, or aspect of the component, that t... |
Section 5163.22 | Life insurance policies.
...ode. The designation shall be made on a form provided by the department. |
Section 5164.33 | Denying, terminating, and suspending provider agreements.
...rect payments of medicaid funds in the form of salary, shared fees, contracts, kickbacks, or rebates from or through any other medicaid provider or risk contractor. (C) An individual, provider, or entity excluded from participation in the medicaid program under this section may request a reconsideration of the exclusion. The director shall adopt rules under section 5164.02 of the Revised Code governing the pr... |
Section 5164.35 | Provider offenses.
...al knowledge of the representation or information involved, acting in deliberate ignorance of the truth or falsity of the representation or information involved, or acting in reckless disregard of the truth or falsity of the representation or information involved, deceives another or causes another to be deceived by any false or misleading representation, by withholding information, by preventing another from acquiri... |
Section 5164.36 | Credible allegation of fraud or disqualifying indictment; suspension of provider agreement.
...rogram or relates to or results from performing management or administrative services relating to furnishing medicaid services under the medicaid program. (b) The indictment charges the person with committing an act that would constitute a disqualifying offense. (3) "Disqualifying offense" means any of the offenses listed or described in divisions (A)(3)(a) to (e) of section 109.572 of the Revised Code. (4) ... |
Section 5164.47 | Contracting for review and analysis, quality assurance and quality review.
...solutions for patient safety, which was formed for the purpose of improving pediatric patient care in this state, which performs functions that are included within the functions of a peer review committee as defined in section 2305.25 of the Revised Code, and which consists of all of the following members: Akron children's hospital, Cincinnati children's hospital medical center, Cleveland clinic children's hosp... |
Section 5165.04 | Assessment to determine level of care.
...ing facility. The assessment may be performed concurrently with a long-term care consultation provided under section 173.42 of the Revised Code. To the maximum extent possible, the assessment shall be based on information from the resident assessment instrument specified in rules authorized by section 5165.191 of the Revised Code. The assessment shall also be based on criteria and procedures established in rul... |
Section 5165.103 | Completion of cost reports.
...t reports shall be completed using the form prescribed under section 5165.104 of the Revised Code and in accordance with the guidelines established under that section. |
Section 5165.105 | Addendum for disputed costs.
...develop an addendum to the cost report form that a nursing facility provider may use to set forth costs that the provider believes the department may dispute. The department may consider such costs in determining a nursing facility's medicaid payment rate. If the department does not consider such costs in determining a nursing facility's medicaid payment rate, the provider may seek reconsideration of the deter... |
Section 5165.158 | Private room incentive payment.
...oms by submitting an application in the form and manner prescribed by the department. The department shall begin accepting applications for approval of category one private rooms on January 1, 2024, and category two private rooms on March 1, 2024. The department may specify evidence that an applicant must supply to demonstrate that a room meets the definition of a private room under section 5165.01 of the Revised Cod... |
Section 5165.68 | Statement of deficiencies.
...cribe the incidents or other facts that form the basis of the department's determination of the existence of each finding and deficiency. A failure by the survey team to completely disclose in the exit interview every finding that may result from the survey does not affect the validity of any finding or deficiency cited in the statement of deficiencies. On request of the facility, the department shall provide a... |
Section 5165.77 | Emergency remedies.
... survey team intends to make that could form the basis of a determination that an emergency exists. (D) The department of medicaid or contracting agency shall deliver a written order issued under division (A)(1) of this section terminating a nursing facility's participation in the medicaid program to the facility within five days after the exit interview. If the facility alleges, at any time prior to the later ... |
Section 5165.771 | Special focus facility program.
...ny standard health survey findings that form the basis, in whole or in part, for an order issued pursuant to division (B) of this section terminating a nursing facility's participation in the medicaid program. Any challenges to standard health survey findings shall be made to the department of health. (2) A nursing facility shall not appeal to the department of medicaid a determination by the United States centers... |
Section 5166.20 | Additional Medicaid waiver components for home and community-based services.
...nity-based services are provided in the form of any of the following: (a) Early intervention and supportive services for children under three years of age who have developmental delays or disabilities the department determines are significant; (b) Therapeutic services for children who have autism; (c) Specialized habilitative services for individuals who are eighteen years of age or older and have autism. (B) No ... |
Section 5166.308 | Nursing assistance by home care attendants; unauthorized actions.
...nt to do any of the following: (A) Perform a task that is outside of the health care professional's scope of practice; (B) Assist the consumer with the self-administration of a medication, including a schedule II, schedule III, schedule IV, or schedule V drug unless both of the following apply: (1) The medication is administered orally, topically, or via a gastrostomy tube or jejunostomy tube, including throu... |
Section 5167.35 | Meaningful employment of Medicaid recipients.
...ilize a standard health risk assessment form established by the medicaid director to identify enrollees to receive assistance under the program established by this section. (C)(1) Not later than six months after the effective date of this section, the medicaid director and the director of job and family services shall convene a workgroup. The workgroup shall consist of the following members, selected by the direct... |
Section 5168.02 | [Repealed effective 10/16/2025] Adoption of rules.
...mines appropriate; (2) Prescribe the form for submission of cost reports under section 5168.05 of the Revised Code; (3) Establish, in accordance with division (A) of section 5168.06 of the Revised Code, the assessment rate or rates to be applied to hospitals under that section; (4) Establish schedules for hospitals to pay installments on their assessments under section 5168.06 of the Revised Code and for gov... |
Section 5168.14 | Providing basic, medically necessary hospital-level services to individuals who are residents.
...t to the department of medicaid, in the form and manner prescribed by the department, information on the number and identity of patients served pursuant to this section. (D) This section applies beginning May 22, 1992, regardless of whether rules specifying the services to be provided have been adopted. Nothing in this section alters the scope or limits the obligation of any governmental entity or program, includi... |