Ohio Revised Code Search
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Section 5168.62 | Monthly report.
...(A) Each ICF/IID shall submit to the department of developmental disabilities a monthly report containing the number of the ICF/IID's inpatient days for that month. A report is due not later than fifteen days after the last day of the month for which it is submitted. Reports shall be submitted to the department in a manner the department shall prescribe. The department may review the data included in a report for acc... |
Section 5168.63 | Determination, notice and payment of quarterly franchise permit fee.
...(A) Not later than the last day of each October, January, April, and July, the department of developmental disabilities shall notify, electronically or by United States postal service, each ICF/IID of the amount of the quarterly franchise permit fee the ICF/IID has been assessed under section 5168.61 of the Revised Code. (B) Subject to section 5168.64 of the Revised Code, each ICF/IID shall pay its quarterly franch... |
Section 5168.64 | Consequences of converting beds to providing home and community-based services.
...If the operator of an ICF/IID converts, pursuant to section 5124.60 or 5124.61 of the Revised Code, all of the ICF/IID's beds to providing home and community-based services and the operator's provider agreement for the ICF/IID is terminated as a consequence, the department of developmental disabilities shall terminate the ICF/IID's franchise permit fee effective on the first day of the quarter immediately following t... |
Section 5168.65 | Assessing penalty for overdue installment.
...If an ICF/IID fails to pay the full amount of an installment when due, the department of developmental disabilities may assess a five per cent penalty on the amount due for each month or fraction thereof the installment is overdue. |
Section 5168.66 | Additional sanctions for overdue installment.
...(A) In addition to assessing a penalty pursuant to section 5168.65 of the Revised Code, the department of developmental disabilities may do any of the following if an ICF/IID fails to pay the full amount of a franchise permit fee installment when due: (1) Withhold an amount less than or equal to the installment and penalty assessed under section 5168.65 of the Revised Code from a medicaid payment due the ICF/... |
Section 5168.67 | Appeal of fee.
...(A) An ICF/IID may appeal the franchise permit fee imposed under section 5168.61 of the Revised Code solely on the grounds that the department of developmental disabilities committed a material error in determining the amount of the fee. A request for an appeal must be received by the department not later than fifteen days after the date the department notifies the ICF/IID of the fee and must include written material... |
Section 5168.68 | Home and community-based services for persons with developmental disabilities fund.
...There is hereby created in the state treasury the home and community-based services for persons with developmental disabilities fund. All installment payments and penalties paid by an ICF/IID under sections 5168.63 and 5168.65 of the Revised Code shall be deposited into the fund. As soon as possible after the end of each quarter, the medicaid director shall certify to the director of budget and management the amount ... |
Section 5168.69 | Department of developmental disabilities operating and services fund.
...There is hereby created in the state treasury the department of developmental disabilities operating and services fund. The fund shall consist of the money transferred to it under section 5168.68 of the Revised Code. The money in the fund shall be used for the expenses of the programs that the department of developmental disabilities administers and the department's administrative expenses. |
Section 5168.70 | Investigation; enforcement.
...The department of developmental disabilities may make any investigation it considers appropriate to obtain information necessary to fulfill its duties under sections 5168.60 to 5168.71 of the Revised Code. At the request of the department, the attorney general shall aid in any such investigations. The attorney general shall institute and prosecute all necessary actions for the enforcement of sections 5168.60 to... |
Section 5168.71 | Adoption of rules.
...Code if the United States secretary of health and human services determines that the franchise permit fee imposed under section 5168.61 of the Revised Code is an impermissible health care-related tax under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w); (B) Establish any other requirements or procedures the director considers necessary to implement sections 5168.60 to 5168.71 of the Revised Cod... |
Section 5168.75 | Definitions for R.C. 5168.75 to 5168.86.
...68.86 of the Revised Code: (A) "Basic health care services" means all of the services listed in division (A)(1) of section 1751.01 of the Revised Code. (B) "Care management system" has the same meaning as in section 5167.01 of the Revised Code. (C) "Dual eligible individual" has the same meaning as in section 5160.01 of the Revised Code. (D) "Franchise fee" means the fee imposed on health insuring corporation... |
Section 5168.76 | Franchise fee on health insuring corporation plans.
... month beginning with July 2017 on each health insuring corporation plan. The franchise fee shall have a component based on Ohio medicaid member months and another component based on other Ohio member months. (B) The department of medicaid shall determine the amount of the monthly franchise fee to be imposed on a health insuring corporation plan under the component based on Ohio medicaid member months. The deter... |
Section 5168.77 | Component due dates.
...ear shall be paid in one payment. If a health insuring corporation administers multiple health insuring corporation plans, the corporation shall pay the total amount due for all of the plans under the component of the franchise fee based on Ohio medicaid member months in one payment and pay the total amount due for all of the plans under the component of the franchise fee based on other Ohio member months in one pay... |
Section 5168.78 | Documentation.
...partment of medicaid may request that a health insuring corporation provide the department documentation the department needs to verify the amount of the franchise fees imposed on the health insuring corporation plans administered by the corporation and to ensure the corporation's compliance with sections 5168.75 to 5168.86 of the Revised Code. On receipt of the request, the health insuring corporation shall provide ... |
Section 5168.79 | Determination of higher fee.
...at the amount of a franchise fee that a health insuring corporation paid is less than the amount it should have paid, the department shall notify the health insuring corporation. Except as otherwise provided by the results of a reconsideration conducted under section 5168.80 of the Revised Code, the health insuring corporation shall pay the amount due. |
Section 5168.81 | Penalty for overdue payments.
...If a health insuring corporation fails to pay the full amount of a component of a franchise fee when due, the department of medicaid may assess a ten per cent penalty on the amount due for each month or fraction thereof that the component of the franchise fee is overdue. |
Section 5168.82 | Waiver required.
...anchise fee shall not be imposed on any health insuring corporation plan unless there is in effect a waiver authorizing the franchise fee issued by the United States secretary of health and human services pursuant to section 1903(w)(3)(E) of the "Social Security Act," 42 U.S.C. 1396b(w)(3)(E). |
Section 5168.83 | Refunds.
...amount of franchise fees imposed on all health insuring corporation plans under section 5168.76 of the Revised Code during a fiscal year exceeds the indirect guarantee percentage of the net patient revenue for all health insuring corporations for that fiscal year and seventy-five per cent or more of all health insuring corporations receive enhanced medicaid payments or other state payments equal to seventy-five per c... |
Section 5168.84 | Modification or cessation.
...t the franchise fee is an impermissible health care-related tax under section 1903(w) of the "Social Security Act," 42 U.S.C. 1396b(w), the department of medicaid shall do either of the following as appropriate: (A) Modify the imposition of the franchise fee, including (if necessary) the amount of the franchise fee, in a manner needed for the United States centers to reverse its determination; (B) Take all necessar... |
Section 5168.85 | Health insuring corporation franchise fee fund.
...ereby created in the state treasury the health insuring corporation franchise fee fund. All payments and penalties paid by health insuring corporations under sections 5168.77, 5168.79, and 5168.81 of the Revised Code shall be deposited into the fund. money in the fund shall be used to make medicaid payments to medicaid providers and medicaid managed care organizations. (B) Any interest or other investment proceeds e... |
Section 5168.86 | Implementation.
...The medicaid director may adopt rules in accordance with Chapter 119. as necessary to implement sections 5168.75 to 5168.86 of the Revised Code. |
Section 5168.90 | Quarterly report to JMOC.
... 5168.61 of the Revised Code; (d) The health insuring corporation franchise fee under section 5168.76 of the Revised Code. (2) If there is a rate increase for any of the fee rates listed under division (A)(1) of this section pending before the centers for medicare and medicaid services. (B) The director may adopt rules under section 5162.02 of the Revised Code to compile and submit the reports required under th... |
Section 5168.99 | [Repealed effective 10/16/2025] Penalties.
...his section shall be deposited into the health care/medicaid support and recoveries fund created by section 5162.52 of the Revised Code. |
Section 5168.991 | [Repealed effective 10/16/2025] Offsetting unpaid penalty.
...The department of medicaid may offset the amount of a hospital's unpaid penalty imposed under section 5168.99 of the Revised Code from one or more payments due the hospital under the medicaid program. The total amount that may be offset from one or more payments shall not exceed the amount of the unpaid penalty. |