Ohio Revised Code Search

...eemed medically necessary by a treating health care provider for proper breast cancer screening in accordance with applicable American college of radiology guidelines, including magnetic resonance imaging, ultrasound, or molecular breast imaging. (B) The medicaid program shall cover all of the following: (1) To detect the presence of breast cancer in adult women, screening mammography; (2) To detect the presenc...

...(A) Except as provided in division (C) of this section, the medicaid program shall cover prescribed, orally administered cancer medications on at least the same basis that it covers intraveneously administered or injected cancer medications. In implementing this section, the department of medicaid shall not institute cost-sharing requirements under section 5162.20 of the Revised Code for prescribed, orally admi...

...(A) As used in this section: (1) "Benzodiazepine" has the same meaning as in section 3719.01 of the Revised Code. (2) "Chronic pain" has the same meaning as in section 4731.052 of the Revised Code. (3) "Hospice care program" and "hospice patient" have the same meanings as in section 3712.01 of the Revised Code. (4) "Opioid analgesic" has the same meaning as in section 3719.01 of the Revised Code. (5) "Prescriber...

...ically transmit that data securely to a health care provider in a different location for that provider's examination of the data; (b) The technology has been approved by the United States food and drug administration for remote data acquisition, if required under federal law. (2) For remote fetal nonstress tests, the CPT code includes a place of service modifier for at home monitoring using remote monitoring so...

...recommended in the United States public health service clinical practice guidelines on treating tobacco use and dependence; (b) Services associated with more than two attempts to quit using tobacco within a twelve-month period. (C) The director of health shall adopt rules in accordance with Chapter 119. of the Revised Code that establish standards and procedures for approving the forms of tobacco cessation medic...

...The medicaid program may cover a health care service that a pharmacist provides to a medicaid recipient in accordance with Chapter 4729. of the Revised Code, including any of the following services: (A) Managing drug therapy under a consult agreement pursuant to section 4729.39 of the Revised Code; (B) Administering immunizations in accordance with section 4729.41 of the Revised Code; (C) Administering drugs ...

... this section: (1) "Community mental health services provider or facility" means a community mental health services provider or facility that has its community mental health services certified by the department of mental health and addiction services under section 5119.36 of the Revised Code or by the department of children and youth under section 5103.03 of the Revised Code. (2) "Mental health professional" me...

...The medicaid program may cover one or more state plan home and community-based services that the department of medicaid selects for coverage. A medicaid recipient of any age may receive a state plan home and community-based service if the recipient has countable income not exceeding two hundred twenty-five per cent of the federal poverty line, has a medical need for the service, and meets all other eligibility requir...

...The medicaid program may cover tobacco cessation services in addition to the services that must be covered under section 5164.10 of the Revised Code or may exclude coverage of additional tobacco cessation services.

...The medicaid program shall not cover prescribed drugs for treatment of erectile dysfunction.

...The departments of developmental disabilities and medicaid may approve, reduce, deny, or terminate a medicaid service included in the individual service plan developed for a medicaid recipient with a developmental disability who is eligible for medicaid case management services. If either department approves, reduces, denies, or terminates a service, that department shall timely notify the medicaid recipient that the...

... designed to provide information about healthcheck to all persons eligible for the program or their parents or guardians. The department shall ensure that its methods of providing information are effective. Each entity that distributes or accepts applications for medicaid shall prominently display a notice that complies with the methods of providing information about healthcheck established under this sectio...

... developmental disabilities, and mental health and addiction services shall participate in the development of the revisions and shall utilize the revised system.

...ivities of a peer review committee of a health care entity and shall be subject to sections 2305.25 to 2305.253 of the Revised Code. The medicaid director may adopt rules under section 5164.02 of the Revised Code as necessary to implement this section. Any rules adopted shall be consistent with the requirements that apply to medicare advantage organizations under 42 C.F.R. 422.204.

...No person or government entity may participate in the medicaid program as a medicaid provider without a valid provider agreement with the department of medicaid.

...cian, group practice, clinic, or other health care facility that employs the physician assistant. (2) A claim for medicaid payment may be submitted by the physician assistant who provided the service only if the physician assistant has a valid provider agreement. When submitting the claim, the physician assistant shall use only the medicaid provider number the department has assigned to the physician assistan...

...cation fees shall be deposited into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code. Application fees are nonrefundable when collected in accordance with 42 C.F.R. 455.460(a). (D) The medicaid director shall adopt rules under section 5164.02 of the Revised Code as necessary to implement this section, including a rule establishing the amount of the application fe...

...(A) Each medicaid provider agreement shall expire not later than five years from its effective date. If a provider agreement entered into before the effective date of this amendment does not have a time limit, the department of medicaid shall convert the agreement to a provider agreement with a time limit. (B) The medicaid director shall adopt rules under section 5164.02 of the Revised Code as necessary to i...

...(A) The medicaid director may do the following for any reason permitted or required by federal law and when the director determines that the action is in the best interests of medicaid recipients or the state: (1) Deny, refuse to revalidate, suspend, or terminate a provider agreement; (2) Exclude an individual, provider of services or goods, or other entity from participation in the medicaid program. (B) No ...

...ucted pursuant to this section is not a public record for the purposes of section 149.43 of the Revised Code and shall not be made available to any person other than the following: (1) The person who is the subject of the criminal records check or the person's representative; (2) The medicaid director and the staff of the department who are involved in the administration of the medicaid program; (3) The depa...

...ction 109.5721 of the Revised Code is a public record for the purposes of section 149.43 of the Revised Code. Such a report or notice shall not be made available to any person other than the following: (1) The person who is the subject of the criminal records check or the person's representative; (2) The medicaid director and the staff of the department who are involved in the administration of the medicaid pro...

...equest made under this section is not a public record for the purposes of section 149.43 of the Revised Code and shall not be made available to any person other than the following: (1) The applicant or employee who is the subject of the criminal records check or the representative of the applicant or employee; (2) The chief administrator of the waiver agency that requires the applicant or employee to request th...

...(A) As used in this section, "owner" means any person having at least five per cent ownership in a medicaid provider. (B)(1) No medicaid provider shall do any of the following: (a) By deception, obtain or attempt to obtain payments under the medicaid program to which the provider is not entitled pursuant to the provider's provider agreement, or the rules of the federal government or the medicaid director relati...

...(A) As used in this section: (1) "Credible allegation of fraud" has the same meaning as in 42 C.F.R. 455.2, except that for purposes of this section any reference in that regulation to the "state" or the "state medicaid agency" means the department of medicaid. (2) "Disqualifying indictment" means an indictment of a medicaid provider or its officer, authorized agent, associate, manager, employee, or, if the pro...

...er of immediate and serious harm to the health, safety, or welfare of medicaid recipients. The department also shall suspend all medicaid payments to the medicaid provider for services rendered, regardless of the date that the services were rendered, when the department suspends the provider agreement under this section. (B) If the department suspends a medicaid provider's provider agreement under this section, the...