Ohio Revised Code Search

...4729.65 of the Revised Code; (vi) The medicaid fraud investigation and prosecution fund; (vii) The bureau of criminal identification and investigation asset forfeiture and cost reimbursement fund created by section 109.521 of the Revised Code; (viii) The casino control commission enforcement fund created by section 3772.36 of the Revised Code; (ix) The auditor of state investigation and forfeiture trust fund ...

... the child if the child is eligible for medicaid. The party shall include in the notice the name and address of the insurer. Any physician, clinical nurse specialist, certified nurse practitioner, hospital, or other provider of medical services covered by the medicaid program who is notified under this section of the existence of a health insurance or health care policy, contract, or plan with coverage for children w...

...maximum amount permitted a recipient of medicaid. The notice shall include an explanation of the potential effect on the resident's eligibility for medicaid if the amount in the resident's accounts and the petty cash fund, plus the value of other nonexempt resources, exceeds the maximum assets a medicaid recipient may retain. (D) Except as otherwise provided in section 3.061 of the Revised Code, each home that mana...

...; (3) The resident is a recipient of medicaid and the home's participation in the medicaid program has been involuntarily terminated or denied by the federal government; (4) The resident is a beneficiary under the medicare program and the home's certification under the medicare program has been involuntarily terminated or denied by the federal government. (E) If a resident is to be transferred or discharged ...

... "This home is not a participant in the medicaid program administered by the Ohio department of medicaid. Consequently, you may be discharged from this home if you are unable to pay for the services provided by this home." If the prospective resident has a sponsor whose identity is made known to the home, the home shall also inform the sponsor, before admission of the resident, of the home's status relative to ...

...be considered for employment. (b) The medicaid program does not reimburse the home health agency for the fee it pays to the bureau under this section. (F) Divisions (C) to (E) of this section do not apply with regard to an applicant or employee if the applicant or employee is referred to a home health agency by an employment service that supplies full-time, part-time, or temporary staff for positions that involve...

...ome and community-based services" means medicaid-funded home and community-based services specified in division (A)(1) of section 5166.20 of the Revised Code provided under the medicaid waiver components the department of developmental disabilities administers pursuant to section 5166.21 of the Revised Code. Except as provided in section 5123.0412 of the Revised Code, home and community-based services provided under ...

... home and community-based services and medicaid case management services. The rules shall provide for private providers of the services to receive one hundred per cent of the medicaid allowable payment amount and for government providers of the services to receive the federal share of the medicaid allowable payment, less the amount withheld as a fee under section 5123.0412 of the Revised Code. The rules shall ...

...rter per cent of the total value of all medicaid paid claims for home and community-based services provided during the year to an individual eligible for services from the county board. A county board shall not pass on to a provider of home and community-based services the cost of a fee charged to the county board under this section. (B) The amounts collected from the fees charged under this section shall be depos...

...noses or special care needs for which a medicaid payment rate is set pursuant to section 5124.152 of the Revised Code; (B) The medicaid director and director of developmental disabilities determine that there is a need under the medicaid program for the proposed new residential facility or modification to the existing residential facility and that approving the application for the initial residential facility l...

...(A) As used in this section: (1) "Medicaid-certified capacity" has the same meaning as in section 5124.01 of the Revised Code. (2) "Residential facility" has the same meaning as in section 5123.19 of the Revised Code. (B)(1) The director of developmental disabilities may change the terms of an agreement entered into with a county board of developmental disabilities or private, nonprofit agency pursuant to section ...

...of developmental disabilities may pay a medicaid rate add-on to an ICF/IID provider for outlier ICF/IID services the ICF/IID provides to residents identified as needing intensive behavioral support services, if the provider applies to the department to receive the rate add-on and the department approves the application. The department may approve a provider's application if both of the following apply: (1) The prov...

...United States centers for medicare and medicaid services under the medicaid program by completing all final fiscal audits not already completed and performing all other appropriate actions the department determines to be necessary. The department shall issue an initial debt summary report on this matter not later than sixty days after the date the exiting operator files the properly completed cost report requir...

... dual eligible individual is a medicare-medicaid enrollee (MME). (B) "Exchange" has the same meaning as in 45 C.F.R. 155.20. (C) "Federal financial participation" means the federal government's share of expenditures made by an entity in implementing a medical assistance program. (D) "Medical assistance program" means all of the following: (1) The medicaid program; (2) The children's health insurance program; (3...

...The medicaid director's rules governing medicaid are binding on other state agencies and political subdivisions that administer one or more components of the medicaid program, or one or more aspects of a component, pursuant to contracts entered into under section 5162.35 of the Revised Code. No state agency or political subdivision may establish, by rule or otherwise, a policy governing medicaid that is incons...

...ty shall transfer to the department of medicaid the money in the personal needs allowance account of a resident of the home or facility who was a medicaid recipient no earlier than sixty days but not later than ninety days after the resident dies. The home or facility shall transfer the money even though the owner or operator of the facility or home has not been issued letters testamentary or letters of admini...

...The department of medicaid shall seek federal financial participation for each claim a qualified medicaid school provider properly submits to the department under section 5162.361 of the Revised Code. The department shall disburse the federal financial participation the department receives from the federal government for such a claim to the qualified medicaid school provider that submitted the claim. The depart...

...The department of medicaid may retain or collect a percentage of the federal financial participation included in a supplemental medicaid payment to one or more medicaid providers owned or operated by a state agency or political subdivision that brings the payment to such provider or providers to the upper payment limit established by 42 C.F.R. 447.272. If the department retains or collects a percentage of that federa...

...rug manufacturers to the department of medicaid in accordance with a rebate agreement required by the "Social Security Act," section 1927, 42 U.S.C. 1396r-8; (3) The federal share of all supplemental rebates paid by drug manufacturers to the department of medicaid in accordance with the supplemental drug rebate program established under section 5164.755 of the Revised Code; (4) Except as otherwise provided by...

...dual who applies to participate in the medicaid buy-in for workers with disabilities program. "Earned income" has the meaning established by rules authorized by section 5163.098 of the Revised Code. "Employed individual with a medically improved disability" has the same meaning as in the "Social Security Act," section 1905(v), 42 U.S.C. 1396d(v). "Family" means an applicant or participant and the spouse and d...

... or molecular breast imaging. (B) The medicaid program shall cover all of the following: (1) To detect the presence of breast cancer in adult women, screening mammography; (2) To detect the presence of breast cancer in adult women meeting any of the conditions described in division (C)(2) of this section, supplemental breast cancer screening; (3) To detect the presence of cervical cancer, cytologic screening....

...d 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 administered cancer medi...

...(A) The medicaid program shall cover both of the following, subject to division (C) of this section: (1) All tobacco cessation medications approved by the United States food and drug administration; (2) All forms of tobacco cessation services recommended by the United States preventive services task force, including individual, group, and telephone counseling and any combination thereof. (B) The department of m...

...an December 31, 2018, the department of medicaid shall develop and implement revisions to the system by which persons and government entities become and remain medicaid providers so that there is a single system of records for the system and the persons and government entities do not have to submit duplicate data to the state to become or remain medicaid providers for any component or aspect of a component of the med...

...Under the medicaid program, any amount determined to be owed the state by a final fiscal audit conducted pursuant to section 5164.55 of the Revised Code, upon the issuance of an adjudication order pursuant to Chapter 119. of the Revised Code that contains a finding that there is a preponderance of the evidence that a medicaid provider will liquidate assets or file bankruptcy in order to prevent payment of the a...