Ohio Revised Code Search

...olator in accordance with rules adopted under section 5162.02 of the Revised Code.

...the data collection and data warehouse functions of the medicaid data warehouse system, including the ability to link the data sets of all agencies serving medicaid recipients. The assessment of the data system shall include functions related to fraud and abuse detection, program management and budgeting, and performance measurement capabilities of all agencies serving medicaid recipients, including the department...

...r the obligations are paid shall be deposited in the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code. (E) This section does not apply to requests for medicaid recipient or claims payment data, data from reports of audits conducted under section 5165.109 of the Revised Code, or extracts or analyses of any of the foregoing data that are for any of the following purpo...

...s section shall also be delineated by county and the urban and rural communities specified in rules adopted under section 3701.142 of the Revised Code. (5) The number of prenatal, postpartum, and child health visits; (6) The estimated number of enrolled women of child-bearing age who use a tobacco product; (7) The estimated number of enrolled women of child-bearing age who participate in a tobacco cessation pro...

... made available on the department's web site. The department shall submit a copy of each report to the chairpersons and ranking members of the committees of the house of representatives and senate with jurisdiction over medicaid and the legislative service commission.

...st of the program; (C) The average amount of earned income of participants' families; (D) The average amount of time participants have participated in the program; (E) The types of other health insurance participants have been able to obtain.

...ll provide a copy of the report to the general assembly in accordance with section 101.68 of the Revised Code. The director also shall make the report available to the public.

...ilable on the department's internet web site. (D) The department shall make available the data sources and methodology used to complete the scorecard to any person or government entity on request.

...)(1) or (2) of this section, as applicable. Each report shall be submitted to the commission on infant mortality and the general assembly. Submissions to the general assembly shall be made in accordance with section 101.68 of the Revised Code. (B) The department shall make a presentation on each report at the first meeting of the commission on infant mortality that follows the report's submission to the commission....

...y recommending measures to reduce costs under that program. The department shall submit its report to the governor.

... of aiding the department's evaluations under this section, medicaid managed care organizations shall collect and submit to the department relevant data about members of the expansion eligibility group who are enrolled in the organizations' medicaid MCO plans. The department may request that a medicaid managed care organization collect and submit to the department additional data the department needs for the evaluati...

...rovided on the form; (4) Refuses to release any funds to the state. (B) When providing notice under this section, the director shall include any letter or information that is provided by the United States centers for medicare and medicaid services in its questioning or deciding not to certify the form, as well as any correspondences from the department in response. (C) The notice required under this section sha...

... components of the medicaid program, unless the government entity receives medicaid payments for providing medicaid services. "Federal health care programs" has the same meaning as in the "Social Security Act," section 1128B, 42 U.S.C. 1320a-7b(f). (B) Each entity that receives or makes in a federal fiscal year payments under the medicaid program, either through the medicaid state plan or a federal medicaid wa...

...icaid data warehouse system established under section 5162.11 of the Revised Code.

...vice to a medicaid recipient who is unable to pay a required copayment for the service. (2) Division (B)(1) of this section shall not be considered to do either of the following with regard to a medicaid recipient who is unable to pay a required copayment: (a) Relieve the medicaid recipient from the obligation to pay a copayment; (b) Prohibit the provider from attempting to collect an unpaid copayment. (C) Ex...

...terest at the time of death (to the extent of the interest), including assets conveyed to a survivor, heir, or assign of the individual through joint tenancy, tenancy in common, survivorship, life estate, living trust, or other arrangement. (2) "Institution" means a nursing facility, ICF/IID, or a medical institution. (3) "Permanently institutionalized individual" means an individual to whom all of the follow...

.... 1382c, considered to be blind or disabled; (3) The recipient's sibling who has an equity interest in the home and resided in the home for at least one year immediately before the date of the recipient's admission to the institution. (D) The medicaid director or a person designated by the director shall sign a certificate to effectuate a lien required to be imposed under this section. The county department of ...

... any person or government entity to collect the amounts due on behalf of the attorney general. The attorney general, in entering into a contract under this section, shall comply with all of the requirements that must be met for the state to receive federal financial participation for the costs incurred in entering into the contract and carrying out actions under the contract. The contract may provide for the ...

...he facility or home has not been issued letters testamentary or letters of administration concerning the resident's estate. (C) If funeral or burial expenses for a resident of a home or residential facility who has died have not been paid and the only resource the resident had that could be used to pay for the expenses is the money in the resident's personal needs allowance account, or all other resources of t...

... Revised Code permitting county departments of job and family services to take action to recover benefits incorrectly paid on behalf of medicaid recipients. The rules shall provide for recovery by the following methods: (1) Soliciting voluntary payments from recipients or from persons holding property in which a recipient has a legal or equitable interest; (2) Obtaining a lien on property pursuant to division...

... health care services to a child eligible for medicaid. (2) The person has received payment from a third party for the costs of such services but has not used the payment to reimburse either the other parent or guardian of the child or the provider of the services. (C) Claims for current and past due child support shall take priority over claims under division (B) of this section.

...viders participating under a preprint unless exempted by a value-based purchasing agreement approved by the United States centers for medicare and medicaid services. (c) The program shall be subject to an evaluation plan, in accordance with 42 C.F.R. 438.6(c)(2)(ii)(D). (2) The program shall be for hospital providers and services or professional services provided by hospitals. (3) Unless otherwise determined by...

...e directed payment programs established under section 5162.25 of the Revised Code.

...llance system; (2) The incidence, prevalence, costs, and medical consequences of cancer on medicaid recipients and other low-income populations. (B) The medicaid director shall consult with the director of health in creating the medicaid administrative claiming program.

...ct the amount of funds a county is entitled to receive under sections 5101.16 and 5101.161 of the Revised Code.