Ohio Revised Code Search

...To be eligible for the medicaid-funded component of the assisted living program, an individual must meet all of the following requirements: (A) Need an intermediate level of care as determined by an assessment conducted under section 173.546 of the Revised Code; (B) While receiving assisted living services under the medicaid-funded component, reside in a residential care facility that is authorized by a valid...

...ible individuals may be enrolled in the medicaid-funded component of the assisted living program in accordance with this section. An individual is eligible for the assisted living program's home first component if both of the following apply: (1) The individual has been determined to be eligible for the medicaid-funded component of the assisted living program. (2) At least one of the following applies: (a) T...

...0, 2019, the person is eligible for the medicaid program or is a medicaid recipient. (iv) Except as provided in division (A)(7)(b)(iii) of this section, the person is not eligible for or a recipient, enrollee, or beneficiary of any governmental health care program. (8) "Nonprofit health care referral organization" means an entity that is not operated for profit and refers patients to, or arranges for the provisio...

...h the certification requirements of the medicaid program cites the defendant's receipt of the residential habilitation, care, and treatment in the facility as being inappropriate under the certification requirements, if the defendant's receipt of the residential habilitation, care, and treatment in the facility potentially jeopardizes the facility's continued receipt of federal medicaid moneys, and if as a result of ...

...dents residing in the district who are medicaid recipients. The director shall furnish such numbers upon receipt of lists of student names furnished by the district board, in such form as the director may require. The medicaid director shall provide the director of developmental disabilities with the data necessary for compliance with this section. Section 3319.321 of the Revised Code does not apply to the ...

... section 3517.01 of the Revised Code. "Medicaid provider" has the same meaning as in section 5164.01 of the Revised Code. (B) No candidate for the office of attorney general or county prosecutor or such a candidate's campaign committee shall knowingly accept any contribution from a medicaid provider or from any person having an ownership interest in the medicaid provider. (C) Whoever violates this section is g...

...tate treasury the department of health medicaid fund. All funds the department of health receives for the purpose of paying the expenses the department incurs under the medicaid program shall be deposited into the fund. The department shall use the money in the fund to pay the expenses the department incurs under the medicaid program.

...ded, or nursing facility beds under the medicaid program, Title XIX of the "Social Security Act," 49 Stat. 286 (1965), 42 U.S.C. 1396, as amended; (3) An increase of hospital beds reported in an application submitted under section 3722.03 of the Revised Code as long-term care beds. (B) For the purpose of implementing this section, the director shall do all of the following: (1) Not later than October 1, 2023...

... United States centers for medicare and medicaid services regulations, the compassionate caregiver shall comply with all regulations and guidance issued by the centers for medicare and medicaid services, as well as the facility's visitor policy established under division (D) of this section. When visiting a resident in a long-term care facility that is not governed by centers for medicare and medicaid services regula...

...by the federal centers for medicare and medicaid services or an organization acceptable to the department under division (C) of this section. (2) To be eligible for recognition as a thrombectomy-capable stroke center under section 3727.13 of the Revised Code, a hospital must be certified as a thrombectomy-capable stroke center by an accrediting organization approved by the federal centers for medicare and medicaid...

...surance shall notify the department of medicaid of all long-term care insurance policies that meet all of the following requirements: (A) Comply with sections 3923.41 to 3923.48 of the Revised Code and the rules adopted under section 3923.47 of the Revised Code; (B) Provide benefits for home and community-based services in addition to nursing home care; (C) Include case management services in its coverage of...

...ces that are reimbursed under the state medicaid plan: (1) A public nonemergency medical service organization; (2) An urban or rural public transit system; (3) A private nonprofit organization that receives grants under section 5501.07 of the Revised Code. (N)(1) An entity, to the extent it provides ambulette services, if the entity meets all of the following conditions: (a) The entity is certified by the depart...

...e director of behavioral health and the medicaid director shall adopt rules as necessary to implement the residential state supplement program, including the requirements that an individual must satisfy to be eligible for payments under the program. The rules shall be adopted in accordance with Chapter 119. of the Revised Code. The rules adopted by the director of behavioral health may establish the method to be us...

...ment of developmental disabilities for medicaid waiver state match, the department shall expend, in fiscal year 2009 and each fiscal year thereafter, not less than the amount appropriated in appropriation item 322-416, medicaid waiver - state match, in fiscal year 2008 to do both of the following: (1) Pay the nonfederal share of medicaid expenditures for home and community-based services that section 5123....

...(A) The total per medicaid day payment rate determined under section 5124.15 of the Revised Code shall not be paid for ICF/IID services provided by an ICF/IID, or discrete unit of an ICF/IID, designated by the department of developmental disabilities as an outlier ICF/IID or unit. Instead, the provider of a designated outlier ICF/IID or unit shall be paid each fiscal year a total per medicaid day payment rate that th...

...bilities shall redetermine a provider's medicaid payment rate for an ICF/IID using revised information if either of the following results in a determination that the provider received a higher medicaid payment rate for the ICF/IID than the provider was entitled to receive: (1) The provider properly amends a cost report for the ICF/IID under section 5124.107 of the Revised Code; (2) The department makes a finding ...

...ner of an ICF/IID participating in the medicaid program shall provide the department of developmental disabilities and department of medicaid written notice of a facility closure or voluntary termination not less than ninety days before the effective date of the facility closure or voluntary termination. The written notice shall be provided to the department of developmental disabilities and department of medi...

...ll of the items and services covered by medicaid as ICF/IID services and as home and community-based services. The department shall develop the pamphlet in consultation with persons and organizations interested in matters pertaining to individuals eligible for ICF/IID services and home and community-based services. (B) Each ICF/IID provider shall provide the pamphlet to the residents of the ICF/IID who receive ICF/I...

...oard. (2) Employs or contracts with a medicaid services manager, or has entered into an agreement with another county board that employs or contracts with a medicaid services manager to have that medicaid services manager serve both counties. The superintendent of a county board shall not serve as the medicaid services manager of the county board.

...is deemed to refer to the department of medicaid or medicaid director, as the case may be, to the extent the reference is about a duty or authority of the department of medicaid or medicaid director regarding a medical assistance program.

...(A) The department of medicaid shall periodically evaluate the success that members of the expansion eligibility group have with the following: (1) Obtaining employer-sponsored health insurance coverage; (2) Improving health conditions that would otherwise prevent or inhibit stable employment; (3) Improving the conditions of their employment, including duration and hours of employment. (B) For the purpose...

...ministers one or more components of the medicaid program and has reasonable cause to believe that an instance of fraud, waste, or abuse has occurred in the medicaid program shall inform the department of medicaid. The department shall collect the information in the medicaid data warehouse system established under section 5162.11 of the Revised Code.

...The department of medicaid shall certify amounts due under the medicaid estate recovery program instituted under section 5162.21 of the Revised Code to the attorney general pursuant to section 131.02 of the Revised Code. The attorney general may enter into a contract with any person or government entity to collect the amounts due on behalf of the attorney general. The attorney general, in entering into a cont...

...The department of medicaid may enter into contracts with one or more other state agencies or political subdivisions to have the state agency or political subdivision administer one or more components of the medicaid program, or one or more aspects of a component, under the department's supervision. A state agency or political subdivision that enters into such a contract shall comply with the terms of the contra...

...The medicaid director shall create, in accordance with sections 5162.36 to 5 162.366 of the Revised Code, the medicaid school component of the medicaid program.