Ohio Revised Code Search

... was not furnished increased the total medicaid payments to the provider during the fiscal year for which the costs were used to determine a rate. (B) If an exiting operator or owner fails to provide notice of a facility closure or voluntary termination as required by section 5124.50 of the Revised Code, or an exiting operator or owner and entering operator fail to provide notice of a change of operator as req...

...5124.109 of the Revised Code; (B) Any medicaid payment deemed an overpayment under section 5124.523 of the Revised Code; (C) Any penalty the department imposes under section 5124.42 of the Revised Code or section 5124.523 of the Revised Code.

...The department of medicaid may enter into a provider agreement with an entering operator that goes into effect at 12:01 a.m. on the effective date of the change of operator if all of the following requirements are met: (A) The department receives a properly completed written notice required by section 5124.51 of the Revised Code on or before the date required by that section. (B) The department receives both ...

...(A) The department of medicaid may enter into a provider agreement with an entering operator that goes into effect at 12:01 a.m. on the date determined under division (B) of this section if all of the following are the case: (1) The department receives a properly completed written notice required by section 5124.51 of the Revised Code. (2) The department receives, from the entering operator and in accordance ...

...vider agreement with the department of medicaid under section 5124.511 or 5124.512 of the Revised Code shall do all of the following: (A) Comply with all applicable federal statutes and regulations; (B) Comply with section 5124.07 of the Revised Code and all other applicable state statutes and rules; (C) Comply with all the terms and conditions of the exiting operator's provider agreement, including all of t...

...The department of medicaid may enter into a provider agreement as provided in section 5124.07 of the Revised Code, rather than section 5124.511 or 5124.512 of the Revised Code, with an entering operator if the entering operator does not agree to a provider agreement that satisfies the requirements of division (C) of section 5124.513 of the Revised Code. The department may not enter into the provider agreement u...

...h that section, all payments under the medicaid program for the period the cost report is required to cover are deemed overpayments until the date the department receives the properly completed cost report. The department may impose on the exiting operator a penalty of one hundred dollars for each calendar day the properly completed cost report is late.

...iting operator final payment under the medicaid program until the department receives all properly completed cost reports the exiting operator is required to file under sections 5124.10 and 5124.522 of the Revised Code.

...ntal disabilities may request that the medicaid director seek the approval of the United States secretary of health and human services to increase the number of slots available for home and community-based services by a number not exceeding the number of beds that were part of the licensed capacity of a residential facility that had its license revoked or surrendered under section 5123.19 of the Revised Code i...

... of developmental disabilities that has medicaid local administrative authority under division (A) of section 5126.055 of the Revised Code for home and community-based services and refuses to permit an individual to obtain home and community-based services from a qualified and willing provider shall provide the individual timely notice that the individual may appeal under section 5160.31 of the Revised Code. (B) Ex...

... United States centers for medicare and medicaid services. The department or designated entity shall notify the regional council or board of the date on which the audit is to begin. The department may permit a regional council or board to submit changes to the cost report before the audit begins. If the department or designated entity determines that a filed cost report is not auditable, it shall provide written no...

...ncluded in the plans are funded through medicaid; (4) Establish budgets for services based on the individual's assessed needs and preferred ways of meeting those needs; (5) Assist individuals in making selections from among the providers they have chosen; (6) Ensure that services are effectively coordinated and provided by appropriate providers; (7) Establish and implement an ongoing system of monitoring the ...

....47 of the Revised Code do not apply to medicaid-funded supported living. (B) As used in sections 5126.40 to 5126.47 of the Revised Code, "provider" means a person or government entity certified by the director of developmental disabilities to provide supported living for individuals with developmental disabilities. (C) On and after July 1, 1995, each county board of developmental disabilities shall plan and develo...

...The medicaid director shall adopt rules as necessary to implement this chapter.

...state treasury. Money the department of medicaid receives from private foundations in support of pilot projects that promote exemplary programs that enhance programs the department administers shall be credited to the fund. The department may expend the money on such projects, may use the money, to the extent allowable, to match federal financial participation in support of such projects, and shall comply with ...

...The department of medicaid may enter into contracts with private entities to maximize federal revenue without the expenditure of state money. In selecting private entities with which to contract, the department shall engage in a request for proposals process. The department, subject to the approval of the controlling board, may also directly enter into contracts with public entities providing revenue maximizati...

...The department of medicaid may appoint and commission any competent person to serve as a special agent, investigator, or representative to perform a designated duty for and on behalf of the department. Specific credentials shall be given by the department to each person so designated, and each credential shall state the following: (A) The person's name; (B) The agency with which the person is connected; (C) ...

...'s identity. (C)(1) The department of medicaid shall sign a memorandum of understanding with any department, agency, or division as needed to obtain the information specified in division (A) of this section. (2) The department may contract with one or more independent vendors to provide the information identified in division (A) of this section.

...If a violation of section 2913.401 of the Revised Code or a similar offense is suspected in the process of determining or redetermining a medical assistance recipient's eligibility, the case shall be referred for investigation to the county prosecutor of the county in which the medical assistance recipient resides, referred for an administrative disqualification hearing, or both.

...Revised Code prevents the department of medicaid or any entity with which the department has entered into an agreement under section 5160.30 of the Revised Code from doing either of the following: (A) Receiving or reviewing information related to individuals' eligibility for a medical assistance program beyond the information specified in division (A) of section 5160.29 of the Revised Code; (B) Contracting with ...

... (C) of this section, the department of medicaid may accept applications, determine eligibility, redetermine eligibility, and perform related administrative activities for medical assistance programs. (B) The department may enter into agreements with one or more agencies of the federal government, the state, other states, and local governments of this or other states to accept applications, determine eligibil...

...the coverage; (3) Any other data the medicaid director specifies in rules authorized by section 5160.43 of the Revised Code. (B) "Medical support" means support specified as support for the purpose of medical care by order of a court or administrative agency. (C)(1) Subject to division (C)(2) of this section, and except as provided in division (C)(3) of this section, "third party" means all of the following:...

...de to cooperate with the department of medicaid and county department of job and family services, a medical assistance recipient and the recipient's attorney, if any, shall cooperate with each medical provider of the recipient. Cooperation with a medical provider shall consist of disclosing to the provider all information the recipient and attorney, if any, possess that would assist the provider in determining...

...) of this section to the department of medicaid. This assignment includes the rights of the medical assistance recipient and also the rights of any other member of the assistance group for whom the recipient can legally make an assignment. (B) Pursuant to this section, a medical assistance recipient assigns to the department any rights to medical support available to the recipient or other members of the reci...

...(A) The medicaid director may adopt rules under section 5160.02 of the Revised Code to implement sections 5160.35 to 5160.43 of the Revised Code, including rules that specify what constitutes cooperating with efforts to obtain support or payments, or medical assistance payments, and when cooperation may be waived. (B) The department shall adopt rules under section 5160.02 of the Revised Code to do all of the...