Ohio Revised Code Search

...medicaid payments shall not be made for services or items the provider provides during the period beginning on the date the provider agreement expired and ending on the effective date of a subsequent provider agreement, if any, the department enters into with the provider.

...aims for medicaid payment for medicaid services provided to medicaid recipients; (2) Arrange to receive medicaid payment from the department by means of electronic funds transfer. (C) Division (B) of this section does not apply to any of the following: (1) A nursing facility; (2) An ICF/IID; (3) A medicaid managed care organization; (4) Any other medicaid provider or type of medicaid provider designated in ...

...er which medicaid payments for medicaid services are made to an organization on behalf of medicaid providers. The system may not provide for an organization to receive an amount that exceeds, in aggregate, the amount the medicaid program would have paid directly to medicaid providers if not for this section.

... provider a base fee of one dollar for services and a housing trust fund fee of one dollar pursuant to section 317.36 of the Revised Code. In the event of a distribution of the provider's assets pursuant to an order of any court under the law of this state including any receivership, assignment for benefit of creditors, adjudicated insolvency, or similar proceedings, amounts then or thereafter due the state un...

...ct from medicaid payments for medicaid services rendered by a medicaid provider any amounts the provider owes the state as the result of incorrect medicaid payments the department has made to the provider.

... a county department of job and family services to recover excess medicaid payments made to a medicaid provider is not limited by the availability of remedies under sections 5162.21 and 5162.23 of the Revised Code for recovering benefits paid on behalf of medicaid recipients.

...ssociated with the delivery of medicaid services to any medicaid recipient if the hospital refuses without good cause to contract with a medicaid managed care organization that serves the area in which the hospital is located. (B) A hospital is not subject to division (A) of this section if all of the following are the case: (1) The hospital is located in a county in which participants in the care management ...

...ect prescription expenses, professional services and personnel costs, and usual and customary overhead expenses of the terminal distributors surveyed. The survey shall compute and report the cost of dispensing by terminal distributors.

...ation synchronization" means a pharmacy service that synchronizes the filling or refilling of prescriptions in a manner that allows the dispensed drugs to be obtained on the same date each month. (3) "Prescriber" has the same meaning as in section 4729.01 of the Revised Code. (B) With respect to coverage of prescribed drugs, the medicaid program shall provide for medication synchronization for a medicaid recipient ...

...d States secretary of health and human services is authorized to award under section 6071 of the "Deficit Reduction Act of 2005" (Pub. L. No. 109-171, as amended). (B) To the extent funds are available under an MFP demonstration project awarded to the department of medicaid, the director of medicaid may operate the helping Ohioans move, expanding (HOME) choice demonstration component of the medicaid program ...

...ement. (B) The department of veterans services is not required to qualify all of the medicaid-certified beds in a nursing facility the department maintains and operates under section 5907.01 of the Revised Code in the medicare program.

... facility provider for nursing facility services the provider's nursing facility provides during a state fiscal year shall be determined as follows: (A) Determine the sum of all of the following: (1) The per medicaid day payment rate for ancillary and support costs determined for the nursing facility under section 5165.16 of the Revised Code; (2) The per medicaid day payment rate for capital costs determined...

...sed capacity and that were taken out of service for at least thirty days while the rooms were being renovated.

... the Revised Code, the costs of goods, services, and facilities, furnished to a nursing facility provider by a related party are includable in the allowable costs of the provider at the reasonable cost to the related party.

...y, and is eligible for nursing facility services under the medicaid program. (I) "Noncompliance" means failure to substantially meet all applicable certification requirements. (J) "Nursing facility" includes a skilled nursing facility to the extent the context requires. (K) "Repeat finding" or "repeat deficiency" means a finding or deficiency cited pursuant to a survey, to which both of the following apply: ...

...d States secretary of health and human services under the "Social Security Act," sections 1819 and 1919, 42 U.S.C. 1395i-3 and 1396r, and necessary for administration and enforcement of sections 5165.60 to 5165.89 of the Revised Code. If the secretary does not issue appropriate regulations for enforcement of those sections of the "Social Security Act" on or before December 13, 1990, the medicaid director may a...

...d States secretary of health and human services for the enforcement of those sections of the "Social Security Act"; and with the rules authorized by section 5165.61 of the Revised Code. The department and agencies shall enforce sections 5165.60 to 5165.89 of the Revised Code for purposes of the medicare program only to the extent prescribed by the regulations, guidelines, and procedures issued by the secretary...

...d States secretary of health and human services under Title XVIII and Title XIX, sections 5165.65 to 5165.68 of the Revised Code, and rules adopted under section 3721.022 of the Revised Code.

...d States secretary of health and human services under Title XVIII and Title XIX; (b) Includes all the information required by division (A) of this section. (2) The department may consult with the department of medicaid, department of aging, and office of the state long-term care ombudsman program when determining whether a plan, or modification of an existing plan, to which division (A)(4) of this section app...

...d States secretary of health and human services under Title XIX for certification of nursing facilities that have a deficiency. (2) The department of health has approved a plan of correction submitted by the facility under section 5165.69 of the Revised Code for each deficiency. (3) The provider agrees to repay the department of medicaid, in accordance with section 5165.85 of the Revised Code, the federal sha...

...nt with federal law for paying for the services of temporary resident safety assurance managers; (4) Accounting and reporting requirements for temporary resident safety assurance managers; (5) Other procedures and requirements the director determines are necessary to implement this section.

...de to the facility for nursing facility services provided to medicaid eligible residents for a period not to exceed twelve months following the date on which payment of the fine becomes due under division (J) of this section. An amount equal to the amount by which each payment is reduced shall be deposited to the credit of the residents protection fund in accordance with section 5162.66 of the Revised Code.

...ed 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. The notice shall include...

... 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 5166.07 of the Revised Code.

...ndant who provides home care attendant services to a consumer in accordance with the authorizing health care professional's authorization does not engage in the practice of nursing as a registered nurse or in the practice of nursing as a licensed practical nurse in violation of section 4723.03 of the Revised Code. A consumer or the consumer's authorized representative shall report to the appropriate director ...