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The Legislative Service Commission staff updates the Revised Code on an ongoing basis, as it completes its act review of enacted legislation. Updates may be slower during some times of the year, depending on the volume of enacted legislation.

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Section 5162.364 | Adoption of rules for medicaid school component.

...The medicaid director shall adopt rules under section 5162.02 of the Revised Code as necessary to implement the medicaid school component of the medicaid program, including rules that establish or specify all of the following: (A) Conditions a board of education of a city, local, or exempted school district, a governing board of an educational service center, governing authority of a community school established u...

Section 5162.366 | Referrals for certain services under the Medicaid School Program.

...f this section and for the purpose of a medicaid recipient receiving, in accordance with the recipient's individualized education program, physical therapy services, occupational therapy services, speech-language pathology services, or audiology services under the medicaid school component of the medicaid program: (1) A physical therapist is a licensed practitioner of the healing arts for the purpose of 42 C.F.R. 44...

Section 5162.371 | Contracts with department of mental health and addiction services; payment of nonfederal share of medicaid payment.

...If the department of medicaid enters into a contract with the department of mental health and addiction services under section 5162.35 of the Revised Code, the department of medicaid shall pay the nonfederal share of any medicaid payment to a provider for services under the component, or aspect of the component, the department of mental health and addiction services administers.

Section 5162.82 | Payment rate increase report to JMOC.

...ses greater than ten per cent under the medicaid program, the medicaid director shall notify the joint medicaid oversight committee of the increase and be available to testify before the joint medicaid oversight committee regarding the increase.

Section 5163.091 | Qualifications for program.

...Under the medicaid buy-in for workers with disabilities program, an individual who does all of the following in accordance with rules authorized by section 5163.098 of the Revised Code qualifies for the medicaid program: (A) Applies for the medicaid buy-in for workers with disabilities program; (B) Provides satisfactory evidence of all of the following: (1) That the individual is at least sixteen years of age...

Section 5164.06 | Medicaid coverage of occupational therapy services.

...The medicaid program shall cover occupational therapy services provided by an occupational therapist licensed under section 4755.08 of the Revised Code. Coverage shall not be limited to services provided in a hospital or nursing facility. Any licensed occupational therapist may enter into a provider agreement with the department of medicaid to provide occupational therapy services under the medicaid program.

Section 5164.093

...roval from the centers for medicare and medicaid services, the medicaid program shall reimburse medicaid providers for rapid whole genome sequencing for patients who are Medicaid recipients and meet all of the following criteria: (1) The patient is under one year of age. (2) The patient has a complex or acute illness of unknown etiology that is not confirmed to be caused by an environmental exposure, toxic ingest...

Section 5164.16 | Coverage of one or more state plan home and community-based services.

...The medicaid program may cover one or more state plan home and community-based services that the department of medicaid selects for coverage. A medicaid recipient of any age may receive a state plan home and community-based service if the recipient has countable income not exceeding two hundred twenty-five per cent of the federal poverty line, has a medical need for the service, and meets all other eligibility requir...

Section 5164.39 | Hearing not required unless timely requested.

... any action taken by the department of medicaid under section 5164.38 or 5164.57 of the Revised Code or any other state statute governing the medicaid program that requires the department to give notice of an opportunity for a hearing in accordance with Chapter 119. of the Revised Code, if the department gives notice of the opportunity for a hearing but the medicaid provider or other entity subject to the notic...

Section 5164.47 | Contracting for review and analysis, quality assurance and quality review.

...ction 5160.10 of the Revised Code, the medicaid director chooses to contract with a person to perform either or both of the following services, the director may contract with any qualified person, including OCHSPS, to perform the service or services on behalf of the department of medicaid: (1) Review and analyze claims for medicaid services provided to children in accordance with all state and federal laws gov...

Section 5164.60 | Interest on Medicaid provider excess payments.

...Any medicaid provider who, without intent, obtains payments under the medicaid program in excess of the amount to which the provider is entitled is liable for payment of interest on the amount of the excess payments for a period determined by the department, but not to exceed the period from the date on which payment was made to the date on which repayment is made to the state. The interest shall be paid at the avera...

Section 5164.61 | Scope of available remedies for recovery of excess payments.

... and federal law, of the department of medicaid or a county department of job and family services to recover excess medicaid payments made to a medicaid provider is not limited by the availability of remedies under sections 5162.21 and 5162.23 of the Revised Code for recovering benefits paid on behalf of medicaid recipients.

Section 5164.758 | Adoption of rules for implementation of coordinated services program for medicaid users who abuse prescription drugs.

...The medicaid director shall adopt rules under section 5164.02 of the Revised Code to implement a coordinated services program for medicaid recipients who are found to have obtained prescribed drugs under the medicaid program at a frequency or in an amount that is not medically necessary. The program shall be implemented in a manner that is consistent with the "Social Security Act," section 1915(a)(2), 42 U.S.C....

Section 5164.951 | Standards for medicaid payments for services provided through teledentistry.

...f the Revised Code. The department of medicaid shall establish standards for medicaid payments for services provided through teledentistry. The standards shall provide coverage for services to the same extent that those services would be covered by the medicaid program if the services were provided without the use of teledentistry.

Section 5165.031 | Hearing.

...al is an applicant for or recipient of medicaid, the individual may appeal pursuant to section 5160.31 of the Revised Code. If the individual is not an applicant for or recipient of medicaid, the individual may appeal pursuant to a process the department of medicaid shall establish, which shall be similar to the appeals process established by section 5101.35 of the Revised Code. The department of medicaid shal...

Section 5165.07 | Provider agreement requirements.

...of the Revised Code, the department of medicaid shall enter into a provider agreement with a nursing facility operator who applies, and is eligible, for the provider agreement. (B) A provider agreement shall require the department to make medicaid payments to the provider in accordance with this chapter for nursing facility services the nursing facility provides to its residents who are medicaid recipients el...

Section 5165.082 | Qualification of beds.

...the nursing facility participate in the medicaid program shall qualify all of the nursing facility's medicaid-certified beds in the medicare program. The medicaid director may adopt rules under section 5165.02 of the Revised Code to establish the time frame in which a nursing facility must comply with this requirement. (B) The department of veterans services is not required to qualify all of the medicaid-cert...

Section 5165.105 | Addendum for disputed costs.

...The department of medicaid shall develop an addendum to the cost report form that a nursing facility provider may use to set forth costs that the provider believes the department may dispute. The department may consider such costs in determining a nursing facility's medicaid payment rate. If the department does not consider such costs in determining a nursing facility's medicaid payment rate, the provider may s...

Section 5165.154 | Calculating prospective rates for facilities with residents whose care costs are not adequately measured.

...thorized by this section, the total per medicaid day payment rate determined under section 5165.15 of the Revised Code shall not be paid for nursing facility services that a nursing facility not designated as an outlier nursing facility or unit provides to a resident who meets the criteria for admission to a designated outlier nursing facility or unit, as specified in rules authorized by section 5165.153 of the Revis...

Section 5165.16 | Per medicaid day payment rate for ancillary and support costs; peer groups.

...(A) The department of medicaid shall determine each nursing facility's per medicaid day payment rate for ancillary and support costs. A nursing facility's rate shall be the rate determined under division (C) of this section for the nursing facility's peer group. (B) For the purpose of determining nursing facilities' rates for ancillary and support costs, the department shall establish six peer groups composed as f...

Section 5165.17 | Per medicaid day payment rate for reasonable capital costs.

...(A) The department of medicaid shall determine each nursing facility's per medicaid day payment rate for capital costs. A nursing facility's rate shall be the rate determined under division (C) of this section for the nursing facility's peer group. (B) For the purpose of determining nursing facilities' rates for capital costs, the department shall establish six peer groups. (1) Each nursing facility located in an...

Section 5165.23 | Critical access incentive payments to qualified facilities.

...ch state fiscal year, the department of medicaid shall determine the critical access incentive payment for each nursing facility that qualifies as a critical access nursing facility. To qualify as a critical access nursing facility for a state fiscal year, a nursing facility must meet all of the following requirements: (1) The nursing facility must be located in an area that, on December 31, 2011, was designated a...

Section 5165.48 | Nursing facility not required to submit Medicaid claim for Medicare cost-sharing expenses under certain circumstances.

... to submit a claim to the department of medicaid regarding the medicare cost-sharing expenses of a resident of the nursing facility who, under federal law, is eligible to have the medicaid program pay for a part of the cost-sharing expenses if the provider determines that, under rules adopted under section 5165.02 of the Revised Code, the nursing facility would not receive a medicaid payment for any part of the...

Section 5165.525 | Determination of debt of exiting operator; summary report.

...The department of medicaid shall determine the actual amount of debt an exiting operator owes the department 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 f...

Section 5166.03 | Notice of intent to request medicaid waiver.

...The medicaid director may not submit a request to the United States secretary of health and human services for a medicaid waiver under the "Social Security Act," section 1115, 42 U.S.C. 1315, unless the director provides the speaker of the house of representatives and president of the senate written notice of the director's intent to submit the request at least ten days before the date the director submits the ...