Ohio Revised Code Search

...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...

... 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...

...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...

...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 ...

...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.

...A health insuring corporation may request a reconsideration of a determination made by the department of medicaid under section 5168.79 of the Revised Code. A reconsideration may be requested solely on the grounds that the department made a material error in making the determination. A request for a reconsideration must be received by the department not later than fifteen days after the date the department notifies t...

...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.

...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).

...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...

...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...

...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...

...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.

... 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...

...his section shall be deposited into the health care/medicaid support and recoveries fund created by section 5162.52 of the Revised Code.

...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.