Ohio Revised Code Search
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Section 5168.04 | Program year basis of operation.
... of medicaid shall operate the hospital care assurance program established by sections 5168.01 to 5168.14 of the Revised Code on a program year basis. The department shall complete all program requirements on or before the thirtieth day of September each year. |
Section 5168.05 | Submitting financial statement and cost report.
...cial records, show bad debt and charity care separately from courtesy care and contractual allowances. (B) Except as provided in division (C) of this section, each hospital, within one hundred eighty days after the end of the hospital's cost reporting period, shall submit to the department a cost report in a format prescribed in rules adopted under section 5168.02 of the Revised Code. The department shall grant a h... |
Section 5168.06 | Annual assessment.
...essments; (b) The medicaid director determines that adjustments in the amounts of installments are necessary for the administration of sections 5168.01 to 5168.14 of the Revised Code and that unequal installments will not create cash flow difficulties for hospitals. (3) The director may adopt rules under section 5168.02 of the Revised Code establishing alternate schedules for hospitals to pay assessments under th... |
Section 5168.07 | Requiring governmental hospitals to make intergovernmental transfers.
...de and depositing funds into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code. The department shall not require transfers in an amount that, when combined with hospital assessments paid under section 5168.06 of the Revised Code and federal matching funds, produce amounts for distribution to disproportionate share hospitals that, in the aggregate, exceed limits pre... |
Section 5168.08 | Preliminary determination of assessment.
...hat is not in dispute into the hospital care assurance program fund created in section 5168.11 of the Revised Code. (D) In the course of any program year, the department may adjust the assessment rate or rates established in rules pursuant to section 5168.06 of the Revised Code or adjust the amounts of intergovernmental transfers required under section 5168.07 of the Revised Code and, as a result of the adjustment... |
Section 5168.09 | Methodology to pay hospitals sufficient to expend all money in indigent care pool.
...ent to expend all money in the indigent care pool. Under the rules: (A) The department of medicaid may classify similar hospitals into groups and allocate funds for distribution within each group. (B) The department shall establish a method of allocating funds to hospitals, taking into consideration the relative amount of indigent care provided by each hospital or group of hospitals. The amount to be allocated shal... |
Section 5168.10 | Prohibiting replacing funds appropriated for medicaid program.
...pt for moneys deposited into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code, the department of medicaid shall not use money paid to the department under sections 5168.06 and 5168.07 of the Revised Code or money that the department pays to hospitals under section 5168.09 of the Revised Code to replace any funds appropriated by the general assembly for the medicai... |
Section 5168.11 | Hospital care assurance program fund.
... the filing of an appeal, or on court determinations, in the event of appeals, that the hospital is entitled to the funds; (2) The sum of the following being sufficient to distribute the funds after the final determination of any appeals: (a) The available money in the hospital care assurance program fund; (b) The available portion of the money in the health care - federal fund that is credited to that fund pursua... |
Section 5168.13 | Confidentiality.
...Except as specifically required by sections 5168.01 to 5168.14 of the Revised Code, information filed under those sections shall not include any patient-identifying material. Information that includes patient-identifying material is not a public record under section 149.43 of the Revised Code, and no patient-identifying material shall be released publicly by the department of medicaid or by any person under contract ... |
Section 5168.14 | Providing basic, medically necessary hospital-level services to individuals who are residents.
...) of this section, a hospital providing care to an individual under this section is subrogated to the rights of any individual to receive compensation or benefits from any person or governmental entity for the hospital goods and services rendered. (C) Each hospital shall collect and report to the department of medicaid, in the form and manner prescribed by the department, information on the number and identity of ... |
Section 5168.20 | Definitions for R.C. 5168.20 to 5168.28.
...t-reporting data used for purposes of determining the hospital's assessment under section 5168.21 of the Revised Code: (a) Skilled nursing services provided in distinct-part nursing facility units; (b) Home health services; (c) Hospice services; (d) Ambulance services; (e) Renting durable medical equipment; (f) Selling durable medical equipment. (3) "Total facility costs" excludes any costs excluded from a hos... |
Section 5168.21 | Additional annual assessment.
... data or financial statements used to determine a hospital's assessment is subject to the same type of adjustments made to the cost-reporting data under the hospital care assurance program. (B) The period of time specified in this division is the hospital's cost reporting period that ends in the state fiscal year that ends in the federal fiscal year that precedes the federal fiscal year that precedes the assessment ... |
Section 5168.22 | Preliminary determination of assessment amount.
...ssue to each hospital the preliminary determination of the amount that the hospital is assessed under section 5168.21 of the Revised Code for the assessment program year. Except as provided in division (B) of this section, the preliminary determination becomes the final determination for the assessment program year fifteen days after the preliminary determination is issued to the hospital. (B) A hospital may reque... |
Section 5168.23 | Assessment payment schedule.
... payment schedule in each preliminary determination notice the department issues to hospitals under division (A) of section 5168.22 of the Revised Code. |
Section 5168.24 | Audit.
...The department of medicaid may audit a hospital to ensure that the hospital properly pays the amount it is assessed under section 5168.21 of the Revised Code. The department shall take action to recover from a hospital any amount the audit reveals that the hospital should have paid but did not pay. |
Section 5168.25 | Hospital assessment fund.
...There is hereby created in the state treasury the hospital assessment fund. All installment payments made by hospitals under section 5168.23 of the Revised Code and all recoveries the department of medicaid makes under section 5168.24 of the Revised Code shall be deposited into the fund. All investment earnings of the fund shall be credited to the fund. The department shall use money in the fund to pay for the costs ... |
Section 5168.26 | Excluded costs.
...pital's costs associated with providing care to recipients of any of the following: (i) The medicaid program; (ii) The medicare program; (iii) The program for children and youth with special health care needs established under section 3701.023 of the Revised Code; (iv) Services provided under the maternal and child health services block grant established under Title V of the "Social Security Act," 42 U.S.... |
Section 5168.27 | Implementation shall not cause reduction in federal participation for medicaid program.
...The medicaid director shall implement the assessment imposed by section 5168.21 of the Revised Code in a manner that does not cause a reduction in federal financial participation for the medicaid program under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w). |
Section 5168.28 | Determination of assessment as impermissible health care-related tax.
...Revised Code is an impermissible health care-related tax under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w), the medicaid director shall take all necessary actions to cease implementation of sections 5168.20 to 5168.27 of the Revised Code and shall promptly refund to each hospital the amount of money in the hospital assessment fund at the time the refund is to be made that the hospital paid under se... |
Section 5168.43 | Waiver of franchise permit fee.
...caid or medicare. (2) For each nursing facility with more than two hundred beds certified as nursing facility beds under Title XIX, reduce the franchise permit fee rate for a number of the nursing facility's beds specified by the department to the amount necessary to obtain approval of the waiver sought under this section. (B) The effective date of the waiver sought under this section shall be the first day of... |
Section 5168.44 | Approval of waiver; Reduction in franchise permit fee rate.
... permit fee rate in accordance with the terms of the waiver. For purposes of the first fiscal year during which the waiver takes effect, the department shall determine the amount of the reduction not later than the effective date of the waiver and shall mail to each nursing home and hospital qualifying for the reduction notice of the reduction not later than the last day of the first month of the quarter that begins ... |
Section 5168.45 | Increase in franchise permit fee rate.
...ion 5168.42 of the Revised Code: (1) Determine how much money the franchise permit fee would have raised in a fiscal year if not for the waiver; (2) For each nursing home and hospital subject to the franchise permit fee, other than a nursing home or hospital that has its franchise permit fee rate reduced under section 5168.44 of the Revised Code, uniformly increase the amount of the franchise permit fee rate for a ... |
Section 5168.47 | Determination, notice, and payment of annual fee.
...ear, the department of medicaid shall determine the annual franchise permit fee for each nursing home and hospital in accordance with section 5168.42 of the Revised Code and any adjustments made in accordance with sections 5168.44 and 5168.45 of the Revised Code. (B) Not later than the first day of October of each year, the department shall notify, electronically or by United States postal service, each nursing home... |
Section 5168.48 | Redetermination of franchise permit fees.
...r, the department of medicaid shall redetermine each nursing home's and hospital's franchise permit fee if one or more bed surrenders occur during the period beginning on the first day of May of the preceding calendar year and ending on the first day of January of the calendar year in which the redetermination is made. (B) In redetermining nursing homes' and hospitals' franchise permit fees under this section, the d... |
Section 5168.49 | Change of operator; division of franchise permit fees.
...ing the franchise permit fee that was determined for the nursing home or hospital under section 5168.47 of the Revised Code, or redetermined for the nursing home or hospital under section 5168.48 of the Revised Code, for that fiscal year shall be divided proportionally. The exiting operator shall be responsible for paying the amount of the fee that is for the part of the fiscal year that ends on the day before the ef... |