Ohio Revised Code Search
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Section 5165.86 | Delivery of notices.
...partment of medicaid, the department of health, and any contracting agency shall deliver a written notice, statement, or order to a nursing facility under sections 5165.60 to 5165.66 and 5165.69 to 5165.89 of the Revised Code by certified mail, hand delivery, or other means reasonably calculated to provide prompt actual notice. If the notice, statement, or order is mailed, it shall be addressed to the administrator o... |
Section 5165.87 | Appeals.
...(A) Except as provided in division (B) of this section, the following remedies are subject to appeal under Chapter 119. of the Revised Code: (1) An order issued under section 5165.71, 5165.72, 5165.77, or 5165.85 of the Revised Code terminating a nursing facility's participation in the medicaid program; (2) Appointment of a temporary manager of a facility under division (A)(1)(b) or (2)(b) of section 5165.72, o... |
Section 5165.88 | Confidentiality.
...o identify such an individual is not a public record for the purposes of section 149.43 of the Revised Code, and is not subject to inspection and copying under section 1347.08 of the Revised Code. (C) If the department or a contracting agency, or an agency or individual to whom the department or contracting agency was required by court order or for administration or enforcement of a statute relating to nursing... |
Section 5165.89 | Hearing on transfer or discharge of resident who medicaid or medicare beneficiary.
...The department of health shall be the designee of the department of medicaid for the purpose of conducting a hearing pursuant to section 3721.162 of the Revised Code concerning a nursing facility's decision to transfer or discharge a resident if the resident is a medicaid recipient or medicare beneficiary. |
Section 5165.99 | Penalty.
...(A) Whoever violates section 5165.102 or division (E) of section 5165.08 of the Revised Code shall be fined not less than five hundred dollars nor more than one thousand dollars for the first offense and not less than one thousand dollars nor more than five thousand dollars for each subsequent offense. Fines paid under this section shall be deposited in the state treasury to the credit of the general revenue fund. (... |
Section 5166.01 | Definitions.
...nted by the United States department of health and human services under section 1115 or 1915 of the "Social Security Act," 42 U.S.C. 1315 or 1396n. "Medicaid waiver component" does not include the care management system or services delivered under a prepaid inpatient health plan, as defined in 42 C.F.R. 438.2. "Medically fragile child" means an individual who is under eighteen years of age, has intensive health ca... |
Section 5166.02 | Rules governing medicaid waiver components.
...aid services; (6) Safeguards for the health and welfare of medicaid recipients receiving medicaid services under a medicaid waiver component; (7) Procedures for prioritizing and approving for enrollment individuals who are eligible for a home and community-based services medicaid waiver component and choose to be enrolled in the component; (8) Procedures for enforcing the rules, including establishing correc... |
Section 5166.03 | Notice of intent to request medicaid waiver.
...uest 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 request to the United States secretary. T... |
Section 5166.04 | Home and community-based services medicaid waiver components.
...afeguards shall be taken to protect the health and welfare of individuals receiving medicaid services under a component, including safeguards established in rules adopted under section 5166.02 of the Revised Code and safeguards established by licensing and certification requirements that are applicable to the providers of that component's medicaid services. (H) No medicaid services may be provided under a compo... |
Section 5166.041 | Provision of nursing services in a group visit under a home and community-based services medicaid waiver component.
...A medicaid provider of nursing services may provide nursing services in a group visit under a home and community-based services medicaid waiver component if the component covers the nursing services, the number of medicaid recipients who receive the nursing services during the group visit does not exceed four, and all of the following apply to all of those medicaid recipients: (A) They are enrolled in the component;... |
Section 5166.05 | Review of plans of care and individual service plans.
...The department of medicaid may review and approve, modify, or deny written plans of care and individual service plans that section 5166.04 of the Revised Code requires be created for individuals determined eligible for a home and community-based services medicaid waiver component. If a state agency or political subdivision contracts with the department under section 5162.35 of the Revised Code to administer a h... |
Section 5166.06 | Agency records of costs of medicaid waiver components.
...uest to the United States secretary of health and human services, United States comptroller general, and their designees. |
Section 5166.07 | Agency accountable for medicaid waiver components funds.
...Each administrative agency is financially accountable for funds expended for medicaid services covered by the home and community-based services medicaid waiver components that the agency administers. |
Section 5166.08 | Agency contracting for medicaid waiver components; assurance of compliance.
...Each state agency and political subdivision that enters into a contract with the department of medicaid under section 5162.35 of the Revised Code to administer a home and community-based services medicaid waiver component, or one or more aspects of such a component, shall provide the department a written assurance that the agency or subdivision will not violate any of the requirements of sections 5166.01 to 516... |
Section 5166.09 | Reservation of participant capacity for individuals related to active duty military who were receiving services in another state.
...Every home and community-based services medicaid waiver component shall reserve a portion of the participant capacity of the waiver for eligible individuals whose spouse or parent or legal guardian is an active duty military service member and, at the time of the service member's transfer to Ohio, the eligible individual was receiving home and community-based services in another state. |
Section 5166.10 | Transfer of enrollee in one medicaid waiver component to another.
...er does not jeopardize the individual's health or safety. |
Section 5166.11 | Creation of medicaid waiver components for home and community-based services programs.
...(A) As used in this section, "Ohio home care program" means the program the department of medicaid administers that provides state plan services and medicaid waiver component services pursuant to rules adopted for the medicaid program and a medicaid waiver that went into effect July 1, 1998. (B) The department of medicaid may create and administer two or more medicaid waiver components under which home and co... |
Section 5166.121 | Home first component for the Ohio home care waiver program.
...(A) Unless the Ohio home care waiver program is terminated pursuant to section 5165.12 of the Revised Code, the department of medicaid shall establish a home first component for the Ohio home care waiver program. An individual is eligible for the Ohio home care waiver program's home first component if the individual has been determined to be eligible for the Ohio home care waiver program and at least one of the... |
Section 5166.16 | Integrated care delivery system medicaid waiver.
...(A) As used in this section and section 5166.161 of the Revised Code, "ODA or MCD medicaid waiver component" means all of the following: (1) The medicaid-funded component of the PASSPORT program; (2) The medicaid-funded component of the assisted living program; (3) The Ohio home care waiver program. (B) The medicaid director may create a home and community-based services medicaid waiver component as part ... |
Section 5166.161 | Home and community-based services for Holocaust survivors.
...The department of medicaid shall ensure that each ICDS participant who is a survivor of the Holocaust that occurred in Europe during World War II receives, while enrolled in the ICDS medicaid waiver component, home and community-based services of the type and in at least the amount, duration, and scope that the participant is assessed to need and would have received if the participant were enrolled in an ODA or MCD m... |
Section 5166.20 | Additional Medicaid waiver components for home and community-based services.
...dicaid shall seek, accept, and consider public comments. |
Section 5166.21 | Transitions developmental disabilities waiver.
...The department of medicaid shall enter into a contract with the department of developmental disabilities under section 5162.35 of the Revised Code with regard to one or more of the medicaid waiver components created by the department of medicaid under section 5166.20 of the Revised Code. The contract shall include the medicaid waiver component known as the transitions developmental disabilities waiver. The contract s... |
Section 5166.22 | Allocating enrollment numbers to county board of developmental disabilities.
...(A) Subject to division (B) of this section, when the department of developmental disabilities allocates enrollment numbers to a county board of developmental disabilities for home and community-based services specified in division (A)(1) of section 5166.20 of the Revised Code and provided under any of the medicaid waiver components that the department administers under section 5166.21 of the Revised Code, the depart... |
Section 5166.23 | Rules regarding payments for home and community-based services provided under medicaid component.
...g the resources necessary to assure the health and welfare of consumers; (d) Recognize variations in environmental supports available to consumers. (B) As part of the process of adopting rules authorized by this section, the director shall consult with the director of developmental disabilities, representatives of county boards of developmental disabilities, persons who provide the home and community-based se... |
Section 5166.30 | Coverage of home care attendant services.
...attendant services. (4) "Authorizing health care professional" means a health care professional who, pursuant to section 5166.307 of the Revised Code, authorizes a home care attendant to assist a consumer with self-administration of medication, nursing tasks, or both. (5) "Consumer" means an individual to whom all of the following apply: (a) The individual is enrolled in a participating medicaid waiver compo... |