Ohio Revised Code Search

...(A) A nursing home or hospital may appeal the fee assessed under section 5168.42 of the Revised Code, as adjusted under section 5168.44 or 5168.45 of the Revised Code, and redetermined under section 5168.48 of the Revised Code solely on the grounds that the department of medicaid committed a material error in determining or redetermining the amount of the fee. A request for an appeal must be received by the departmen...

...ition of surveyors at the department of health, and to fund quality and consumer information resources. Money in the fund may also be used for the residential state supplement program established under section 5119.41 of the Revised Code. (B) Any money remaining in the nursing home franchise permit fee fund after payments specified in division (A) of this section are made shall be retained in the fund. Any interes...

...The department of medicaid may make any investigation it considers appropriate to obtain information necessary to fulfill its duties under sections 5168.40 to 5168.56 of the Revised Code. At the request of the department, the attorney general shall aid in any such investigations. The attorney general shall institute and prosecute all necessary actions for the enforcement of sections 5168.40 to 5168.56 of the R...

...d by those sections is an impermissible health-care related tax under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w); (B) Establish any requirements or procedures the director considers necessary to implement sections 5168.40 to 5168.56 of the Revised Code.

...y portion of the costs of a broad-based health-care-related tax. If the indirect guarantee percentage changes during a fiscal year, the indirect guarantee percentage is the following: (1) For the part of the fiscal year before the change takes effect, the percentage in effect before the change; (2) For the part of the fiscal year beginning with the date the indirect guarantee percentage changes, the new percentag...

...C)(1) If the United States secretary of health and human services determines that the franchise permit fee established by sections 5168.60 to 5168.71 of the Revised Code would be an impermissible health care-related tax under section 1903(w) of the "Social Security Act," 42 U.S.C. 1396b(w), take all necessary actions to cease implementation of those sections in accordance with rules adopted under section 5168.71 of t...

...hall submit to the department of developmental disabilities a monthly report containing the number of the ICF/IID's inpatient days for that month. A report is due not later than fifteen days after the last day of the month for which it is submitted. Reports shall be submitted to the department in a manner the department shall prescribe. The department may review the data included in a report for accuracy. (B) If an...

...ril, and July, the department of developmental disabilities shall notify, electronically or by United States postal service, each ICF/IID of the amount of the quarterly franchise permit fee the ICF/IID has been assessed under section 5168.61 of the Revised Code. (B) Subject to section 5168.64 of the Revised Code, each ICF/IID shall pay its quarterly franchise permit fee under section 5168.61 of the Revised Code to ...

...a consequence, the department of developmental disabilities shall terminate the ICF/IID's franchise permit fee effective on the first day of the quarter immediately following the quarter in which the conversion takes place.

...ment when due, the department of developmental disabilities may assess a five per cent penalty on the amount due for each month or fraction thereof the installment is overdue.

...Revised Code, the department of developmental disabilities may do any of the following if an ICF/IID fails to pay the full amount of a franchise permit fee installment when due: (1) Withhold an amount less than or equal to the installment and penalty assessed under section 5168.65 of the Revised Code from a medicaid payment due the ICF/IID until the ICF/IID pays the installment and penalty; (2) Offset an amo...

...e grounds that the department of developmental disabilities committed a material error in determining the amount of the fee. A request for an appeal must be received by the department not later than fifteen days after the date the department notifies the ICF/IID of the fee and must include written materials setting forth the basis for the appeal. (B) If an ICF/IID submits a request for an appeal within the time requ...

...-based services for persons with developmental disabilities fund. All installment payments and penalties paid by an ICF/IID under sections 5168.63 and 5168.65 of the Revised Code shall be deposited into the fund. As soon as possible after the end of each quarter, the medicaid director shall certify to the director of budget and management the amount of money that is in the fund as of the last day of that quarter. On ...

...tate treasury the department of developmental disabilities operating and services fund. The fund shall consist of the money transferred to it under section 5168.68 of the Revised Code. The money in the fund shall be used for the expenses of the programs that the department of developmental disabilities administers and the department's administrative expenses.

...The department of developmental disabilities may make any investigation it considers appropriate to obtain information necessary to fulfill its duties under sections 5168.60 to 5168.71 of the Revised Code. At the request of the department, the attorney general shall aid in any such investigations. The attorney general shall institute and prosecute all necessary actions for the enforcement of sections 5168.60 to...

...Code if the United States secretary of health and human services determines that the franchise permit fee imposed under section 5168.61 of the Revised Code is an impermissible health care-related tax under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w); (B) Establish any other requirements or procedures the director considers necessary to implement sections 5168.60 to 5168.71 of the Revised Cod...

...r otherwise makes available, only supplemental health care services or only specialty health care services. (F) "Health insuring corporation plan" means a policy, contract, certificate, or agreement of a health insuring corporation under which the corporation pays for, reimburses, provides, delivers, arranges for, or otherwise makes available basic health care services. "Health insuring corporation plan" does not m...

... month beginning with July 2017 on each health insuring corporation plan. The franchise fee shall have a component based on Ohio medicaid member months and another component based on other Ohio member months. (B) The department of medicaid shall determine the amount of  the monthly franchise fee to be imposed on a health insuring  corporation plan under the component based on Ohio medicaid member  months. The deter...

...ear shall be paid in one payment. If a health insuring corporation administers multiple health insuring corporation plans, the corporation shall pay the total amount due for all of the plans under the component of the franchise fee based on Ohio medicaid member months in one payment and pay the total amount due for all of the plans under the component of the franchise fee based on other Ohio member months in one pay...

...partment of medicaid may request that a health insuring corporation provide the department documentation the department needs to verify the amount of the franchise fees imposed on the health insuring corporation plans administered by the corporation and to ensure the corporation's compliance with sections 5168.75 to 5168.86 of the Revised Code. On receipt of the request, the health insuring corporation shall provide ...

...at the amount of a franchise fee that a health insuring corporation paid is less than the amount it should have paid, the department shall notify the health insuring corporation. Except as otherwise provided by the results of a reconsideration conducted under section 5168.80 of the Revised Code, the health insuring corporation shall pay the amount due.

...A health insuring corporation may request a reconsideration of a determination made by the department of medicaid under section 5168.79 of the Revised Code. A reconsideration may be requested solely on the grounds that the department made a material error in making the determination. A request for a reconsideration must be received by the department not later than fifteen days after the date the department notifies t...

...If a health insuring corporation fails to pay the full amount of a component of a franchise fee when due, the department of medicaid may assess a ten per cent penalty on the amount due for each month or fraction thereof that the component of the franchise fee is overdue.

...anchise fee shall not be imposed on any health insuring corporation plan unless there is in effect a waiver authorizing the franchise fee issued by the United States secretary of health and human services pursuant to section 1903(w)(3)(E) of the "Social Security Act," 42 U.S.C. 1396b(w)(3)(E).

...amount of franchise fees imposed on all health insuring corporation plans under section 5168.76 of the Revised Code during a fiscal year exceeds the indirect guarantee percentage of the net patient revenue for all health insuring corporations for that fiscal year and seventy-five per cent or more of all health insuring corporations receive enhanced medicaid payments or other state payments equal to seventy-five per c...