Ohio Revised Code Search

..., the medicaid director may require an individual seeking to enroll, or who is enrolled, in CHIP part II to pay a premium, deductible, coinsurance payment, or other cost-sharing expense.

...the medicaid director shall require an individual seeking to enroll, or who is enrolled, in CHIP part III to pay the following as a term of enrollment: (A) A premium of not less than forty dollars per month for a family with one individual seeking to enroll, or who is enrolled, in the part; (B) A premium of not less than eighty dollars per month for a family with two individuals seeking to enroll, or who is e...

...A completed application for medicaid shall be treated as an application for the children's health insurance program if the application is for an assistance group that includes a child under nineteen years of age and is denied.

...The medicaid director may contract with a government entity or person to perform the director's administrative duties regarding CHIP part I, part II, part III, two of the parts, or all three parts, other than the duty to submit a state child health plan to the United States secretary of health and human services under section 5161.10 of the Revised Code, the duty to submit a waiver request under section 5161.15...

...ces to provide health assistance to any individual who meets all of the following requirements: (1) Is the parent of a child who is under nineteen years of age, resides with the parent, and is enrolled in the children's health insurance program part I or II or the medicaid program; (2) Is uninsured; (3) Has a family income that does not exceed one hundred per cent of the federal poverty line. (B) A waiver re...

...n 5124.01 of the Revised Code. (10) "Individualized education program" has the same meaning as in section 3323.011 of the Revised Code. (11) "Medicaid managed care organization" has the same meaning as in section 5167.01 of the Revised Code. (12) "Medicaid MCO plan" has the same meaning as in section 5167.01 of the Revised Code. (13) "Medicaid provider" has the same meaning as in section 5164.01 of the Re...

...The medicaid director shall adopt rules as necessary to implement this chapter.

...The medicaid director shall adopt rules under sections 5160.02, 5162.02, 5163.02, 5164.02, 5165.02, 5166.02, and 5167.02 of the Revised Code as necessary to authorize the directors of other state agencies to adopt rules regarding medicaid components, or aspects of medicaid components, the other state agencies administer pursuant to contracts entered into under section 5162.35 of the Revised Code.

...rector's rules governing medicaid are binding on other state agencies and political subdivisions that administer one or more components of the medicaid program, or one or more aspects of a component, pursuant to contracts entered into under section 5162.35 of the Revised Code. No state agency or political subdivision may establish, by rule or otherwise, a policy governing medicaid that is inconsistent with a m...

...For the purpose of the "Social Security Act," section 1902(a)(5), 42 U.S.C. 1396a(a)(5), the department of medicaid shall act as the single state agency to supervise the administration of the medicaid program. As the single state agency, the department shall comply with 42 C.F.R. 431.10(e) and all other federal requirements applicable to the single state agency.

...ern the department's duties concerning individuals' eligibility for medicaid services, under section 5163.02 of the Revised Code; (3) If the rules concern the department's duties concerning financial and operational matters between the department and county departments of job and family services, under section 5162.02 of the Revised Code.

...As used in this section, "state agency" has the same meaning as in section 9.23 of the Revised Code. No provision of Title LI of the Revised Code or any other law of this state that incorporates any provision of federal medicaid law, or that may be construed as requiring the state, a state agency, or any state official or employee to comply with that federal provision, shall be construed as creating a cause of...

...The medicaid program shall be implemented in accordance with all of the following: (A) The medicaid state plan approved by the United States secretary of health and human services, including amendments to the plan approved by the United States secretary; (B) Federal medicaid waivers granted by the United States secretary, including amendments to waivers approved by the United States secretary; (C) Other type...

...(A) Notwithstanding any other state statute except for section 5164.061 of the Revised Code, no component, or aspect of a component, of the medicaid program shall be implemented without all of the following: (1) Subject to division (B) of this section, if the component, or aspect of the component, requires federal approval, receipt of the federal approval; (2) Sufficient federal financial participation for the co...

...The medicaid director shall seek federal approval for all components, and aspects of components, of the medicaid program for which federal approval is needed, except that the director is permitted rather than required to seek federal approval for components, and aspects of components, that state statutes permit rather than require be implemented. Federal approval shall be sought in the following forms as approp...

...and medicaid coverage to any additional individuals or class of individuals or increase any net costs to the state, without first providing notice to the legislative service commission and the standing committees in the house of representatives and the senate with jurisdiction over medicaid. (B) The department shall provide regular updates to those committees, on a schedule determined by the chairpersons of each co...

...The medicaid director may conduct reviews of the medicaid program. The reviews may include physical inspections of records and sites where medicaid services are provided and interviews of medicaid providers and medicaid recipients. If the director determines pursuant to a review that a person or government entity has violated a rule governing the medicaid program, the director may establish a corrective action ...

...(A) The department of medicaid shall enter into an agreement with the department of administrative services for the department of administrative services to contract through competitive selection pursuant to section 125.07 of the Revised Code with a vendor to perform an assessment of the data collection and data warehouse functions of the medicaid data warehouse system, including the ability to link the data sets of ...

...(A) The medicaid director shall enter into a contract with one or more persons to receive and process, on the director's behalf, 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 made by persons who intend to use the items prepared pursuant to the requests for commercial or acad...

... shall make the report available to the public. (C) The department shall provide to the legislative service commission a copy of the data used to calculate the information required in the report under division (A)(16) of this section.

...ayments and expenditures, including the individual and total dollar amounts for claims that were determined to be the result of fraud, waste, or abuse; (2) Federal and state recovered funds, including the dollar amounts per claim and the total dollar amounts concerning fraud, waste, and abuse in the medicaid program; (3) Aggregate data concerning improper payments and ineligible medicaid recipients who received m...

...owing information: (A) The number of individuals who participated in the medicaid buy-in for workers with disabilities program; (B) The cost 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.

... shall make the report available to the public.

...(A) As used in this section, "stillbirth" has the same meaning as in section 5180.12 of the Revised Code. (B) The department of medicaid shall create an infant mortality scorecard. The scorecard shall report all of the following: (1) The performance of the fee-for-service component of medicaid and each medicaid managed care organization on population health measures, including the infant mortality rate, preterm...

...ed in division (A) of this section, the individuals affected by the barriers, and whether the barriers result from policies implemented by the department, medicaid managed care organizations, providers, or others; (b) Recommendations for the expedient removal of the access barriers; (c) An analysis of the performance of the fee-for-service component of medicaid and the performance of each medicaid managed care or...