Ohio Revised Code Search
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Section 5167.47 | Compliance with federal mental health and addiction parity laws.
...(A) When contracting with a medicaid managed care organization, the department of medicaid shall require the medicaid managed care organization to provide to medicaid enrollees the same benefits and rights as required under division (B) of section 3902.36 of the Revised Code. (B) The medicaid director shall do both of the following: (1) Implement and enforce division (B) of section 3902.36 of the Revised Code wit... |
Section 5168.01 | Hospital care assurance program definitions.
...vised by the United States secretary of health and human services pursuant to the "Omnibus Budget Reconciliation Act of 1981," section 673(2), 42 U.S.C. 9902(2). (E) "Governmental hospital" means a county hospital with more than five hundred registered beds or a state-owned and -operated hospital with more than five hundred registered beds. (F)(1) "Hospital" means a nonfederal hospital to which either of the follow... |
Section 5168.02 | Adoption of rules.
...ram for children and youth with special health care needs established under section 3701.023 of the Revised Code; (3) Medicare beneficiaries; (4) Recipients of Title V of the "Social Security Act," 42 U.S.C. 701 et seq.; (5) Any other category of costs deemed appropriate by the director in accordance with Title XIX of the "Social Security Act," 42 U.S.C. 1396 et seq., and the rules adopted under that title. |
Section 5168.03
...06 of the Revised Code is a permissible health care-related tax pursuant to the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w). Whenever the department of medicaid is informed that the assessment is an impermissible health care-related tax, the department shall promptly refund to each hospital the amount of money currently in the hospital care assurance program fund created by section 5168.11 of the Revis... |
Section 5168.04 | Program year basis of operation.
...The department of medicaid shall operate the hospital care assurance program established by sections 5168.01 to 5168.14 of the Revised Code on a program year basis. The department shall complete all program requirements on or before the thirtieth day of September each year. |
Section 5168.05 | Submitting financial statement and cost report.
...be prepared by an independent certified public accountant and reflect an official audit report prepared in a manner consistent with generally accepted accounting principles. The financial statement shall, to the extent that the hospital has sufficient financial records, show bad debt and charity care separately from courtesy care and contractual allowances. (B) Except as provided in division (C) of this section, ea... |
Section 5168.06 | Annual assessment.
...ised Code and depositing funds into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code, there is hereby imposed an assessment on all hospitals. Each hospital's assessment shall be based on total facility costs. All hospitals shall be assessed according to the rate or rates established each program year in rules adopted under section 5168.02 of the Revised Code. The ... |
Section 5168.07 | Requiring governmental hospitals to make intergovernmental transfers.
...ised Code and depositing funds into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code. The department shall not require transfers in an amount that, when combined with hospital assessments paid under section 5168.06 of the Revised Code and federal matching funds, produce amounts for distribution to disproportionate share hospitals that, in the aggregate, exceed lim... |
Section 5168.08 | Preliminary determination of assessment.
... a request, the department shall hold a public hearing not later than thirty days after the preliminary determinations are issued to reconsider the preliminary determinations. The department shall issue to each hospital a written notice of the date, time, and place of the hearing at least ten days prior to the hearing. On the basis of the evidence submitted to the department or presented at the public hearing, the de... |
Section 5168.09 | Methodology to pay hospitals sufficient to expend all money in indigent care pool.
...ogram, including recipients enrolled in health insuring corporations; (2) Total costs, volume, or proportion of services to low-income patients in addition to medicaid recipients, which may include recipients of Title V of the "Social Security Act," 42 U.S.C. 701 et seq.; (3) The amount of uncompensated care provided by the hospital or group of hospitals; (4) Other factors that the director considers to be appropr... |
Section 5168.10 | Prohibiting replacing funds appropriated for medicaid program.
...Except for moneys deposited into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code, the department of medicaid shall not use money paid to the department under sections 5168.06 and 5168.07 of the Revised Code or money that the department pays to hospitals under section 5168.09 of the Revised Code to replace any funds appropriated by the general assembly for the med... |
Section 5168.11 | Hospital care assurance program fund.
...e Revised Code shall be credited to the health care - federal fund created under section 5162.50 of the Revised Code. (C) All distributions of funds to hospitals under section 5168.09 of the Revised Code are conditional on: (1) Expiration of the time for appeals under section 5168.08 of the Revised Code without the filing of an appeal, or on court determinations, in the event of appeals, that the hospital is entitl... |
Section 5168.13 | Confidentiality.
...s patient-identifying material is not a public record under section 149.43 of the Revised Code, and no patient-identifying material shall be released publicly by the department of medicaid or by any person under contract with the department who has access to such information. |
Section 5168.14 | Providing basic, medically necessary hospital-level services to individuals who are residents.
...ram for children and youth with special health care needs established under section 3701.023 of the Revised Code, to pay for hospital services in accordance with state or local law. |
Section 5168.20 | Definitions for R.C. 5168.20 to 5168.28.
...s of whether patients are enrolled in a health insuring corporation. (2) "Total facility costs" excludes all of the following of a hospital's costs as shown on the cost-reporting data used for purposes of determining the hospital's assessment under section 5168.21 of the Revised Code: (a) Skilled nursing services provided in distinct-part nursing facility units; (b) Home health services; (c) Hospice services; (d... |
Section 5168.21 | Additional annual assessment.
...(A) For the purposes specified in section 5168.25 of the Revised Code and subject to section 5168.28 of the Revised Code, there is hereby imposed an assessment on all hospitals each assessment program year. The amount of a hospital's assessment for an assessment program year shall equal the applicable assessment percentage of the hospital's total facility costs for the period of time specified in division (B) of this... |
Section 5168.22 | Preliminary determination of assessment amount.
...(A) Before or during each assessment program year, the department of medicaid shall issue to each hospital the preliminary determination of the amount that the hospital is assessed under section 5168.21 of the Revised Code for the assessment program year. Except as provided in division (B) of this section, the preliminary determination becomes the final determination for the assessment program year fifteen days after... |
Section 5168.23 | Assessment payment schedule.
...Each hospital shall pay the amount it is assessed under section 5168.21 of the Revised Code in accordance with a payment schedule the department of medicaid shall establish for each assessment program year. The department shall consult with the Ohio hospital association before establishing the payment schedule for any assessment program year. The department shall include the payment schedule in each preliminary deter... |
Section 5168.24 | Audit.
...The department of medicaid may audit a hospital to ensure that the hospital properly pays the amount it is assessed under section 5168.21 of the Revised Code. The department shall take action to recover from a hospital any amount the audit reveals that the hospital should have paid but did not pay. |
Section 5168.25 | Hospital assessment fund.
...There is hereby created in the state treasury the hospital assessment fund. All installment payments made by hospitals under section 5168.23 of the Revised Code and all recoveries the department of medicaid makes under section 5168.24 of the Revised Code shall be deposited into the fund. All investment earnings of the fund shall be credited to the fund. The department shall use money in the fund to pay for the costs ... |
Section 5168.26 | Excluded costs.
...ram for children and youth with special health care needs established under section 3701.023 of the Revised Code; (iv) Services provided under the maternal and child health services block grant established under Title V of the "Social Security Act," 42 U.S.C. 701 et seq. (b) Any other category of hospital costs the director deems appropriate under federal law and regulations governing the medicaid program. (... |
Section 5168.27 | Implementation shall not cause reduction in federal participation for medicaid program.
...The medicaid director shall implement the assessment imposed by section 5168.21 of the Revised Code in a manner that does not cause a reduction in federal financial participation for the medicaid program under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w). |
Section 5168.28 | Determination of assessment as impermissible health care-related tax.
...If the United States secretary of health and human services determines that the assessment imposed by section 5168.21 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), the medicaid director shall take all necessary actions to cease implementation of sections 5168.20 to 5168.27 of the Revised Code and shall promptly refund to each hosp... |
Section 5168.40 | Franchise permit fee definitions.
...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 percent... |
Section 5168.41 | Determination of nursing home and hospital long-term care franchise permit fee rate.
...(A) The franchise permit fee rate shall be determined for each fiscal year as follows: (1) Determine the estimated total net patient revenues for all nursing homes and hospital long-term care units for the fiscal year; (2) Multiply the estimated total net patient revenues determined under division (A)(1) of this section by the lesser of the following: (a) The indirect guarantee percentage; (b) Six per cent.... |