State Codes and Statutes

Statutes > Ohio > Title51 > Chapter5111

5111.01 Medicaid eligibility.
5111.011 Determining eligibility for medical assistance.
5111.012 Eligibility for medical assistance of persons living in county.
5111.013 Healthy start program.
5111.014 Medicaid plan amendment making pregnant individual eligible.
5111.015 Tuition payment contract or scholarship excluded from income.
5111.016 Healthcheck program.
5111.017 [Repealed].
5111.018 Coverage of inpatient care and follow-up care for a mother and her newborn.
5111.019 [Renumbered as 5111.0120] Plan amendment making parent of child residing at home eligible.
5111.0110 Breast and cervical cancer prevention and treatment.
5111.0111 Individual receiving independent living services.
5111.0112 Copayment program.
5111.0113 Children eligible for medical assistance through the medicaid program.
5111.0114 Agreement for multiple-state drug purchasing program.
5111.0115 Former Ohio works first participant ineligible due to employment.
5111.0116 Disposal of assets under market value after look-back date.
5111.0117 Real property not homestead after 13-month institutional residence.
5111.0118 Equity interest in home exceeds $500,000.
5111.0119 Confinement of medicaid recipient in correctional facility.
5111.0120 Plan amendment making parent of child residing at home eligible.
5111.0121 Redetermination of eligibility.
5111.02 Rules establishing amount, duration and scope of services.
5111.021 Reimbursement of providers.
5111.022 Lien for amount owed by provider.
5111.023 Mental health services.
5111.024 Screening mammography and cytologic screening for cervical cancer.
5111.025 Manner of payment for community mental health facilities and alcohol and drug addiction services.
5111.027 Medicaid not to cover drugs for erectile dysfunction.
5111.028 Time-limited medicaid provider agreements.
5111.029 Medicaid coverage of occupational therapy services.
5111.0210 Advanced diagnostic imaging services availability under medicaid program.
5111.0211 [Effective 9/13/2010] Nursing facility not required to submit Medicaid claim for Medicare cost-sharing expenses under certain circumstances.
5111.03 Provider offenses.
5111.031 Action against noninstitutional medicaid provider.
5111.032 Criminal records check of provider personnel.
5111.033 Criminal records checks by waiver agencies.
5111.034 Fingerprint impressions and criminal records check independent provider in department administered home and community-based waiver program.
5111.04 Outpatient health facilities.
5111.041 [Repealed].
5111.042 Recipient with developmental disability who is eligible for medicaid case management services.
5111.05 Contracts for examination, processing, and determination of medical assistance claims.
5111.06 Adjudication orders of department.
5111.061 Recovery of medicaid overpayments.
5111.062 Hearing not required unless timely requested.
5111.07 Determining maximum dispensing fee.
5111.071 Dispensing fee.
5111.08 Outpatient drug use review program.
5111.081 Supplemental drug rebate program.
5111.082 State maximum allowable cost program.
5111.083 E-prescribing system.
5111.084 Pharmacy and therapeutics committee.
5111.085 Transferred to 5111.084.
5111.09 Annual report.
5111.091 Quarterly reports on controlling increase in costs.
5111.092 Annual report outlining efforts to minimize medicaid fraud, waste, and abuse.
5111.10 Review of medicaid program - corrective action - sanctions.
5111.101 Information required where annual medicaid payments exceed $5 million.
5111.102 No state cause of action to enforce federal laws.
5111.11 Estate recovery program.
5111.111 Lien against property of recipient or spouse as part of estate recovery program.
5111.112 Certification of amounts due under estate recovery program - collection.
5111.113 Transfer of personal needs allowance account.
5111.114 Deducting personal needs allowance from recipient's income.
5111.12 Recovering benefits incorrectly paid.
5111.121 Recovering health care costs provided to child.
5111.13 Enrolling in group health plan.
5111.14 Case management of nonemergency transportation services.
5111.15 Beneficiary of disability trust.
5111.151 Eligibility determinations for cases involving medical assistance provided pursuant to this chapter.
5111.16 Care management system.
5111.161 [Repealed].
5111.162 Reference by managed care organization to noncontracting participant.
5111.163 Payment of nonsystem provider for emergency services.
5111.17 Managed care system.
5111.171 Financial incentive awards - health care compliance fund.
5111.172 Requiring coverage of prescription drugs for medicaid recipients.
5111.173 Appointment of temporary manager.
5111.174 Disenrolling some or all medicaid recipients enrolled in managed care organization under contract.
5111.175 Records for determining costs.
5111.176 Medicaid health insuring corporation franchise permit fee - managed care assessment fund.
5111.177 Health insuring corporation contract to provide grievance process.
5111.178 Application for federal medicaid requirements waiver.
5111.18 Qualified long-term care insurance partnership program.
5111.181 Life insurance policies.
5111.19 Reimbursement of graduate medical education costs.
5111.191 Payment for graduate medical education costs to noncontracting hospitals.
5111.20 Nursing facilities and intermediate care facilities for mentally retarded definitions.
5111.201 Nursing facility references.
5111.202 Admission of mentally ill person to nursing facility.
5111.203 Hearing.
5111.204 Assessment to determine level of care.
5111.205 [Repealed].
5111.21 [Effective Until 9/17/2010] Paying reasonable costs of services provided by eligible facility.
5111.211 Responsibility for nonfederal share of claims submitted for services.
5111.22 Provider agreement requirements.
5111.221 Calculating rates and making payments.
5111.222 Calculation of payments to nursing facility providers.
5111.223 Facility operator may contract with more than one provider.
5111.23 Paying per resident per day rate for direct care costs.
5111.231 Per resident per day rate for direct care costs.
5111.232 Case-mix scores for nursing facilities.
5111.233 Day programming.
5111.235 Per resident per day rate for other protected costs.
5111.236 Oxygen services for "medically fragile child".
5111.24 Per resident per day rate for ancillary and support costs.
5111.241 Per resident per day rate for indirect care costs - intermediate care facility.
5111.242 Per resident per day rate for tax costs.
5111.243 Per resident per day rate for franchise permit fees.
5111.244 Quality incentive payment for qualifying nursing facilities.
5111.25 Per resident per day rate for reasonable capital costs.
5111.251 Per resident per day rate for reasonable capital costs - intermediate care facility.
5111.252 Amended and Renumbered RC 5123.199.
5111.254 Initial rates for nursing facility with first licensure date after June 30, 2006.
5111.255 Initial rates for intermediate care facility for mentally retarded with first licensure date after June 30, 2006.
5111.257 Rate for added, replaced, or renovated beds.
5111.258 Calculating prospective rates for facilities with residents whose care costs are not otherwise adequately measured.
5111.26 Annual cost report.
5111.261 Limiting compensation of owners, their relatives, administrators, and resident meals outside facility.
5111.262 Claim for medicaid reimbursement for service provided to nursing facility resident.
5111.263 [Repealed].
5111.264 Related party costs to pass through.
5111.265 Cost of operating rights for relocated beds not allowable cost.
5111.266 Cost of franchise permit fee not reimbursable expense.
5111.27 Desk review of cost report.
5111.28 Refund of certain payments by operators.
5111.29 Reconsideration of rate.
5111.291 Computing rate for intermediate care facilities.
5111.30 Termination for non-compliance with installation of fire extinguishing and fire alarm systems.
5111.31 Provider agreement to prohibit certain discriminatory actions.
5111.32 Action against facility for breach of provider agreement or other duties.
5111.33 Reserving bed during temporary absence of resident.
5111.34 Report recommending methodology to transition paying providers.
5111.341 [Repealed].
5111.35 Nursing facility deficiency definitions.
5111.36 Adoption of rules.
5111.37 Enforcement of rules.
5111.38 Contracts with state agencies for enforcement.
5111.39 Annual standard surveys.
5111.40 Exit interview with administrator.
5111.41 Citations for failure to comply with one or more certification requirements.
5111.411 Survey results.
5111.42 Statement of deficiencies.
5111.43 Plan of correction.
5111.44 On-site monitoring.
5111.45 Deficiencies not substantially corrected.
5111.46 Uncorrected deficiencies constituting severity level four findings.
5111.47 Uncorrected deficiencies constituting severity level three and scope level three or four findings.
5111.48 Uncorrected deficiencies constituting severity level one or two or severity level three, scope level two finding.
5111.49 Imposing remedies and fines.
5111.50 Fine collected if termination order does not take effect.
5111.51 Emergency remedies.
5111.52 Terminating provider agreements.
5111.53 Transfer of residents to other appropriate care settings.
5111.54 Qualifications of temporary manager of nursing facility.
5111.55 Residents to whom denial of medicaid payments applies.
5111.56 Fines.
5111.57 Order denying payment when deficiency is not corrected within time limits.
5111.58 Termination of participation for failure to correct deficiency within six months.
5111.59 Delivery of notices.
5111.60 Appeals.
5111.61 Confidentiality.
5111.62 Residents protection fund.
5111.63 Hearing on transfer or discharge of resident who medicaid or medicare beneficiary.
5111.65 [Effective Until 8/31/2010] Notice of facility closure, etc. - definitions.
5111.651 [Effective Until 8/31/2010] Application of notice provisions.
5111.66 Notice of facility closure, termination, or withdrawal of participation.
5111.661 Compliance with Social Security Act required.
5111.67 Operator notice of intent to continue participation.
5111.671 Provider agreement with entering operator.
5111.672 Effective date of provider agreement with entering operator.
5111.673 Entering operator duties under provider agreement.
5111.674 Exiting operator deemed operator pending change.
5111.675 Provider agreement with operator not complying with prior agreement.
5111.676 Medicaid reimbursement adjustments - change of operator.
5111.677 Determination of change of operator - excluded factors.
5111.68 [Effective Until 8/31/2010] Overpayment amounts determined following notice of closure, etc.
5111.681 [Effective Until 8/31/2010] Withholding from medicaid payment due exiting operator.
5111.682 Cost report by exiting operator - waiver.
5111.683 Failure to file cost report - payments deemed overpayments.
5111.684 Final payment withheld pending receipt of cost reports.
5111.685 [Effective Until 8/31/2010] Determination of debt of exiting operator - summary report.
5111.686 [Effective Until 8/31/2010] Release of amount withheld less amounts owed.
5111.687 Release of amount withheld on postponement of change of operator.
5111.688 [Repealed Effective 8/31/2010] Rules prescribing medicaid reimbursement methodology.
5111.689 [Effective 8/31/2010] Rules prescribing medicaid reimbursement methodology.
5111.70 Medicaid buy-in for workers with disabilities program.
5111.701 Qualifications for assistance under program.
5111.702 Resource eligibility limit - annual adjustment.
5111.703 Individual income eligibility limit.
5111.704 Amount of annual individual premium.
5111.705 Eligibility not denied due to RC 5111.851 services.
5111.706 Continued participation where employment ceases.
5111.707 Director to make federally required amendments.
5111.708 Program implementing rules - disregarded income.
5111.709 Medicaid buy-in advisory council.
5111.7010 Consultation with advisory council.
5111.7011 Annual program report - distribution - contents.
5111.71 Plan amendment for medicaid school component.
5111.711 Claim by qualified medicaid school provider.
5111.712 Federal financial participation for medicaid school claims.
5111.713 Administration of medicaid school component.
5111.714 Medicaid school program administrative fund.
5111.715 Implementing rules for medicaid school component.
5111.74 [Repealed].
5111.75 [Repealed].
5111.76 [Repealed].
5111.77, 5111.771 [Repealed].
5111.78 to 5111.80 [Repealed].
5111.81 Amended and Renumbered to RC 5111.085.
5111.811 [Repealed].
5111.82 [Repealed].
5111.84 Notice of intent to request medicaid waiver.
5111.85 Medicaid waiver components.
5111.851 Home and community-based services medicaid waiver components.
5111.852 Review of plans of care and individual service plans.
5111.853 Agency records of costs of medicaid waiver components.
5111.854 Agency accountable for medicaid waiver components funds.
5111.855 Agency contracting for medicaid waiver components - assurance of compliance.
5111.856 Transfer of enrollee in one medicaid waiver component to another.
5111.86 Creation of medicaid home and community-based services programs to replace former programs.
5111.861 Consolidated federal medicaid waiver.
5111.87 Medicaid waivers.
5111.871 Alternative to intermediate care facility for mentally retarded.
5111.872 Allocating enrollment numbers to county board of developmental disabilities.
5111.873 Statewide fee schedules for home and community-based services provided under component of the medicaid program.
5111.874 [Effective Until 8/31/2010] Conversion of beds to home and community-based services.
5111.875 [Effective Until 8/31/2010] Conversion of beds in acquired intermediate care facility.
5111.876 Request for federal approval of conversion of beds.
5111.877 Maximum number of beds approved.
5111.878 Maximum number of beds converted.
5111.879 Reconversion of beds to ICF/MR use.
5111.8710 Implementing rules for conversion of beds.
5111.88 Federal medicaid waivers authorizing components covering home care attendant services.
5111.881 Home care attendant services providers.
5111.882 Continuing education requirements for home care attendants.
5111.883 Responsibilities of home care attendants.
5111.884 Nursing assistance by home care attendants.
5111.885 Nursing assistance by home care attendants - consent and authorization.
5111.886 Nursing assistance by home care attendants - writtent statement providing consent.
5111.887 Nursing assistance by home care attendants - written statement of authorization.
5111.888 Nursing assistance by home care attendants - unauthorized actions.
5111.889 Practice of nursing as registered nurse or licensed practical nurse not allowed by home care attendants.
5111.8810 Authorized representative.
5111.8811 Adoption of rules under section 5111.85.
5111.8812 [Repealed].
5111.8813 [Repealed].
5111.8814 [Repealed].
5111.8815 [Repealed].
5111.8816 [Repealed].
5111.8817 [Repealed].
5111.89 Request to HHS for waiver regarding assisted living program.
5111.891 Eligibility for assisted living program.
5111.892 Staff requirements for assisted living program facility.
5111.893 Contract for evaluation of program cost-effectiveness.
5111.894 [Effective Until 8/31/2010] Assisted living waiting lists - notice of admission - eligibility.
5111.90 Contracts with political subdivisions to pay nonfederal share.
5111.91 Contracts for administration of components.
5111.911 Contract approval required.
5111.912 Department of mental health payment of nonfederal share of medicaid payment.
5111.913 Department of alcohol and drug addiction services payment of nonfederal share of medicaid payment.
5111.914 Agency action to recover overpayment to provider.
5111.915 Contract for data collection and warehouse functions assessment.
5111.92 Retaining or collecting percentage of federal financial participation.
5111.93 Retaining or collecting percentage of supplemental payment.
5111.94 Health care services administration fund.
5111.941 Medicaid revenue and collections fund.
5111.942 Prescription drug rebates fund.
5111.943 Health care-federal fund.
5111.95 Amended and Renumbered RC 5111.033.
5111.96 Amended and Renumbered RC 5111.034.
5111.97 Ohio access success project.
5111.971 Request to HHS for waiver regarding health care services.
5111.98 Powers of director regarding Medicare Prescription Act of 2003.
5111.99 Penalty.

State Codes and Statutes

Statutes > Ohio > Title51 > Chapter5111

5111.01 Medicaid eligibility.
5111.011 Determining eligibility for medical assistance.
5111.012 Eligibility for medical assistance of persons living in county.
5111.013 Healthy start program.
5111.014 Medicaid plan amendment making pregnant individual eligible.
5111.015 Tuition payment contract or scholarship excluded from income.
5111.016 Healthcheck program.
5111.017 [Repealed].
5111.018 Coverage of inpatient care and follow-up care for a mother and her newborn.
5111.019 [Renumbered as 5111.0120] Plan amendment making parent of child residing at home eligible.
5111.0110 Breast and cervical cancer prevention and treatment.
5111.0111 Individual receiving independent living services.
5111.0112 Copayment program.
5111.0113 Children eligible for medical assistance through the medicaid program.
5111.0114 Agreement for multiple-state drug purchasing program.
5111.0115 Former Ohio works first participant ineligible due to employment.
5111.0116 Disposal of assets under market value after look-back date.
5111.0117 Real property not homestead after 13-month institutional residence.
5111.0118 Equity interest in home exceeds $500,000.
5111.0119 Confinement of medicaid recipient in correctional facility.
5111.0120 Plan amendment making parent of child residing at home eligible.
5111.0121 Redetermination of eligibility.
5111.02 Rules establishing amount, duration and scope of services.
5111.021 Reimbursement of providers.
5111.022 Lien for amount owed by provider.
5111.023 Mental health services.
5111.024 Screening mammography and cytologic screening for cervical cancer.
5111.025 Manner of payment for community mental health facilities and alcohol and drug addiction services.
5111.027 Medicaid not to cover drugs for erectile dysfunction.
5111.028 Time-limited medicaid provider agreements.
5111.029 Medicaid coverage of occupational therapy services.
5111.0210 Advanced diagnostic imaging services availability under medicaid program.
5111.0211 [Effective 9/13/2010] Nursing facility not required to submit Medicaid claim for Medicare cost-sharing expenses under certain circumstances.
5111.03 Provider offenses.
5111.031 Action against noninstitutional medicaid provider.
5111.032 Criminal records check of provider personnel.
5111.033 Criminal records checks by waiver agencies.
5111.034 Fingerprint impressions and criminal records check independent provider in department administered home and community-based waiver program.
5111.04 Outpatient health facilities.
5111.041 [Repealed].
5111.042 Recipient with developmental disability who is eligible for medicaid case management services.
5111.05 Contracts for examination, processing, and determination of medical assistance claims.
5111.06 Adjudication orders of department.
5111.061 Recovery of medicaid overpayments.
5111.062 Hearing not required unless timely requested.
5111.07 Determining maximum dispensing fee.
5111.071 Dispensing fee.
5111.08 Outpatient drug use review program.
5111.081 Supplemental drug rebate program.
5111.082 State maximum allowable cost program.
5111.083 E-prescribing system.
5111.084 Pharmacy and therapeutics committee.
5111.085 Transferred to 5111.084.
5111.09 Annual report.
5111.091 Quarterly reports on controlling increase in costs.
5111.092 Annual report outlining efforts to minimize medicaid fraud, waste, and abuse.
5111.10 Review of medicaid program - corrective action - sanctions.
5111.101 Information required where annual medicaid payments exceed $5 million.
5111.102 No state cause of action to enforce federal laws.
5111.11 Estate recovery program.
5111.111 Lien against property of recipient or spouse as part of estate recovery program.
5111.112 Certification of amounts due under estate recovery program - collection.
5111.113 Transfer of personal needs allowance account.
5111.114 Deducting personal needs allowance from recipient's income.
5111.12 Recovering benefits incorrectly paid.
5111.121 Recovering health care costs provided to child.
5111.13 Enrolling in group health plan.
5111.14 Case management of nonemergency transportation services.
5111.15 Beneficiary of disability trust.
5111.151 Eligibility determinations for cases involving medical assistance provided pursuant to this chapter.
5111.16 Care management system.
5111.161 [Repealed].
5111.162 Reference by managed care organization to noncontracting participant.
5111.163 Payment of nonsystem provider for emergency services.
5111.17 Managed care system.
5111.171 Financial incentive awards - health care compliance fund.
5111.172 Requiring coverage of prescription drugs for medicaid recipients.
5111.173 Appointment of temporary manager.
5111.174 Disenrolling some or all medicaid recipients enrolled in managed care organization under contract.
5111.175 Records for determining costs.
5111.176 Medicaid health insuring corporation franchise permit fee - managed care assessment fund.
5111.177 Health insuring corporation contract to provide grievance process.
5111.178 Application for federal medicaid requirements waiver.
5111.18 Qualified long-term care insurance partnership program.
5111.181 Life insurance policies.
5111.19 Reimbursement of graduate medical education costs.
5111.191 Payment for graduate medical education costs to noncontracting hospitals.
5111.20 Nursing facilities and intermediate care facilities for mentally retarded definitions.
5111.201 Nursing facility references.
5111.202 Admission of mentally ill person to nursing facility.
5111.203 Hearing.
5111.204 Assessment to determine level of care.
5111.205 [Repealed].
5111.21 [Effective Until 9/17/2010] Paying reasonable costs of services provided by eligible facility.
5111.211 Responsibility for nonfederal share of claims submitted for services.
5111.22 Provider agreement requirements.
5111.221 Calculating rates and making payments.
5111.222 Calculation of payments to nursing facility providers.
5111.223 Facility operator may contract with more than one provider.
5111.23 Paying per resident per day rate for direct care costs.
5111.231 Per resident per day rate for direct care costs.
5111.232 Case-mix scores for nursing facilities.
5111.233 Day programming.
5111.235 Per resident per day rate for other protected costs.
5111.236 Oxygen services for "medically fragile child".
5111.24 Per resident per day rate for ancillary and support costs.
5111.241 Per resident per day rate for indirect care costs - intermediate care facility.
5111.242 Per resident per day rate for tax costs.
5111.243 Per resident per day rate for franchise permit fees.
5111.244 Quality incentive payment for qualifying nursing facilities.
5111.25 Per resident per day rate for reasonable capital costs.
5111.251 Per resident per day rate for reasonable capital costs - intermediate care facility.
5111.252 Amended and Renumbered RC 5123.199.
5111.254 Initial rates for nursing facility with first licensure date after June 30, 2006.
5111.255 Initial rates for intermediate care facility for mentally retarded with first licensure date after June 30, 2006.
5111.257 Rate for added, replaced, or renovated beds.
5111.258 Calculating prospective rates for facilities with residents whose care costs are not otherwise adequately measured.
5111.26 Annual cost report.
5111.261 Limiting compensation of owners, their relatives, administrators, and resident meals outside facility.
5111.262 Claim for medicaid reimbursement for service provided to nursing facility resident.
5111.263 [Repealed].
5111.264 Related party costs to pass through.
5111.265 Cost of operating rights for relocated beds not allowable cost.
5111.266 Cost of franchise permit fee not reimbursable expense.
5111.27 Desk review of cost report.
5111.28 Refund of certain payments by operators.
5111.29 Reconsideration of rate.
5111.291 Computing rate for intermediate care facilities.
5111.30 Termination for non-compliance with installation of fire extinguishing and fire alarm systems.
5111.31 Provider agreement to prohibit certain discriminatory actions.
5111.32 Action against facility for breach of provider agreement or other duties.
5111.33 Reserving bed during temporary absence of resident.
5111.34 Report recommending methodology to transition paying providers.
5111.341 [Repealed].
5111.35 Nursing facility deficiency definitions.
5111.36 Adoption of rules.
5111.37 Enforcement of rules.
5111.38 Contracts with state agencies for enforcement.
5111.39 Annual standard surveys.
5111.40 Exit interview with administrator.
5111.41 Citations for failure to comply with one or more certification requirements.
5111.411 Survey results.
5111.42 Statement of deficiencies.
5111.43 Plan of correction.
5111.44 On-site monitoring.
5111.45 Deficiencies not substantially corrected.
5111.46 Uncorrected deficiencies constituting severity level four findings.
5111.47 Uncorrected deficiencies constituting severity level three and scope level three or four findings.
5111.48 Uncorrected deficiencies constituting severity level one or two or severity level three, scope level two finding.
5111.49 Imposing remedies and fines.
5111.50 Fine collected if termination order does not take effect.
5111.51 Emergency remedies.
5111.52 Terminating provider agreements.
5111.53 Transfer of residents to other appropriate care settings.
5111.54 Qualifications of temporary manager of nursing facility.
5111.55 Residents to whom denial of medicaid payments applies.
5111.56 Fines.
5111.57 Order denying payment when deficiency is not corrected within time limits.
5111.58 Termination of participation for failure to correct deficiency within six months.
5111.59 Delivery of notices.
5111.60 Appeals.
5111.61 Confidentiality.
5111.62 Residents protection fund.
5111.63 Hearing on transfer or discharge of resident who medicaid or medicare beneficiary.
5111.65 [Effective Until 8/31/2010] Notice of facility closure, etc. - definitions.
5111.651 [Effective Until 8/31/2010] Application of notice provisions.
5111.66 Notice of facility closure, termination, or withdrawal of participation.
5111.661 Compliance with Social Security Act required.
5111.67 Operator notice of intent to continue participation.
5111.671 Provider agreement with entering operator.
5111.672 Effective date of provider agreement with entering operator.
5111.673 Entering operator duties under provider agreement.
5111.674 Exiting operator deemed operator pending change.
5111.675 Provider agreement with operator not complying with prior agreement.
5111.676 Medicaid reimbursement adjustments - change of operator.
5111.677 Determination of change of operator - excluded factors.
5111.68 [Effective Until 8/31/2010] Overpayment amounts determined following notice of closure, etc.
5111.681 [Effective Until 8/31/2010] Withholding from medicaid payment due exiting operator.
5111.682 Cost report by exiting operator - waiver.
5111.683 Failure to file cost report - payments deemed overpayments.
5111.684 Final payment withheld pending receipt of cost reports.
5111.685 [Effective Until 8/31/2010] Determination of debt of exiting operator - summary report.
5111.686 [Effective Until 8/31/2010] Release of amount withheld less amounts owed.
5111.687 Release of amount withheld on postponement of change of operator.
5111.688 [Repealed Effective 8/31/2010] Rules prescribing medicaid reimbursement methodology.
5111.689 [Effective 8/31/2010] Rules prescribing medicaid reimbursement methodology.
5111.70 Medicaid buy-in for workers with disabilities program.
5111.701 Qualifications for assistance under program.
5111.702 Resource eligibility limit - annual adjustment.
5111.703 Individual income eligibility limit.
5111.704 Amount of annual individual premium.
5111.705 Eligibility not denied due to RC 5111.851 services.
5111.706 Continued participation where employment ceases.
5111.707 Director to make federally required amendments.
5111.708 Program implementing rules - disregarded income.
5111.709 Medicaid buy-in advisory council.
5111.7010 Consultation with advisory council.
5111.7011 Annual program report - distribution - contents.
5111.71 Plan amendment for medicaid school component.
5111.711 Claim by qualified medicaid school provider.
5111.712 Federal financial participation for medicaid school claims.
5111.713 Administration of medicaid school component.
5111.714 Medicaid school program administrative fund.
5111.715 Implementing rules for medicaid school component.
5111.74 [Repealed].
5111.75 [Repealed].
5111.76 [Repealed].
5111.77, 5111.771 [Repealed].
5111.78 to 5111.80 [Repealed].
5111.81 Amended and Renumbered to RC 5111.085.
5111.811 [Repealed].
5111.82 [Repealed].
5111.84 Notice of intent to request medicaid waiver.
5111.85 Medicaid waiver components.
5111.851 Home and community-based services medicaid waiver components.
5111.852 Review of plans of care and individual service plans.
5111.853 Agency records of costs of medicaid waiver components.
5111.854 Agency accountable for medicaid waiver components funds.
5111.855 Agency contracting for medicaid waiver components - assurance of compliance.
5111.856 Transfer of enrollee in one medicaid waiver component to another.
5111.86 Creation of medicaid home and community-based services programs to replace former programs.
5111.861 Consolidated federal medicaid waiver.
5111.87 Medicaid waivers.
5111.871 Alternative to intermediate care facility for mentally retarded.
5111.872 Allocating enrollment numbers to county board of developmental disabilities.
5111.873 Statewide fee schedules for home and community-based services provided under component of the medicaid program.
5111.874 [Effective Until 8/31/2010] Conversion of beds to home and community-based services.
5111.875 [Effective Until 8/31/2010] Conversion of beds in acquired intermediate care facility.
5111.876 Request for federal approval of conversion of beds.
5111.877 Maximum number of beds approved.
5111.878 Maximum number of beds converted.
5111.879 Reconversion of beds to ICF/MR use.
5111.8710 Implementing rules for conversion of beds.
5111.88 Federal medicaid waivers authorizing components covering home care attendant services.
5111.881 Home care attendant services providers.
5111.882 Continuing education requirements for home care attendants.
5111.883 Responsibilities of home care attendants.
5111.884 Nursing assistance by home care attendants.
5111.885 Nursing assistance by home care attendants - consent and authorization.
5111.886 Nursing assistance by home care attendants - writtent statement providing consent.
5111.887 Nursing assistance by home care attendants - written statement of authorization.
5111.888 Nursing assistance by home care attendants - unauthorized actions.
5111.889 Practice of nursing as registered nurse or licensed practical nurse not allowed by home care attendants.
5111.8810 Authorized representative.
5111.8811 Adoption of rules under section 5111.85.
5111.8812 [Repealed].
5111.8813 [Repealed].
5111.8814 [Repealed].
5111.8815 [Repealed].
5111.8816 [Repealed].
5111.8817 [Repealed].
5111.89 Request to HHS for waiver regarding assisted living program.
5111.891 Eligibility for assisted living program.
5111.892 Staff requirements for assisted living program facility.
5111.893 Contract for evaluation of program cost-effectiveness.
5111.894 [Effective Until 8/31/2010] Assisted living waiting lists - notice of admission - eligibility.
5111.90 Contracts with political subdivisions to pay nonfederal share.
5111.91 Contracts for administration of components.
5111.911 Contract approval required.
5111.912 Department of mental health payment of nonfederal share of medicaid payment.
5111.913 Department of alcohol and drug addiction services payment of nonfederal share of medicaid payment.
5111.914 Agency action to recover overpayment to provider.
5111.915 Contract for data collection and warehouse functions assessment.
5111.92 Retaining or collecting percentage of federal financial participation.
5111.93 Retaining or collecting percentage of supplemental payment.
5111.94 Health care services administration fund.
5111.941 Medicaid revenue and collections fund.
5111.942 Prescription drug rebates fund.
5111.943 Health care-federal fund.
5111.95 Amended and Renumbered RC 5111.033.
5111.96 Amended and Renumbered RC 5111.034.
5111.97 Ohio access success project.
5111.971 Request to HHS for waiver regarding health care services.
5111.98 Powers of director regarding Medicare Prescription Act of 2003.
5111.99 Penalty.

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Statutes > Ohio > Title51 > Chapter5111

5111.01 Medicaid eligibility.
5111.011 Determining eligibility for medical assistance.
5111.012 Eligibility for medical assistance of persons living in county.
5111.013 Healthy start program.
5111.014 Medicaid plan amendment making pregnant individual eligible.
5111.015 Tuition payment contract or scholarship excluded from income.
5111.016 Healthcheck program.
5111.017 [Repealed].
5111.018 Coverage of inpatient care and follow-up care for a mother and her newborn.
5111.019 [Renumbered as 5111.0120] Plan amendment making parent of child residing at home eligible.
5111.0110 Breast and cervical cancer prevention and treatment.
5111.0111 Individual receiving independent living services.
5111.0112 Copayment program.
5111.0113 Children eligible for medical assistance through the medicaid program.
5111.0114 Agreement for multiple-state drug purchasing program.
5111.0115 Former Ohio works first participant ineligible due to employment.
5111.0116 Disposal of assets under market value after look-back date.
5111.0117 Real property not homestead after 13-month institutional residence.
5111.0118 Equity interest in home exceeds $500,000.
5111.0119 Confinement of medicaid recipient in correctional facility.
5111.0120 Plan amendment making parent of child residing at home eligible.
5111.0121 Redetermination of eligibility.
5111.02 Rules establishing amount, duration and scope of services.
5111.021 Reimbursement of providers.
5111.022 Lien for amount owed by provider.
5111.023 Mental health services.
5111.024 Screening mammography and cytologic screening for cervical cancer.
5111.025 Manner of payment for community mental health facilities and alcohol and drug addiction services.
5111.027 Medicaid not to cover drugs for erectile dysfunction.
5111.028 Time-limited medicaid provider agreements.
5111.029 Medicaid coverage of occupational therapy services.
5111.0210 Advanced diagnostic imaging services availability under medicaid program.
5111.0211 [Effective 9/13/2010] Nursing facility not required to submit Medicaid claim for Medicare cost-sharing expenses under certain circumstances.
5111.03 Provider offenses.
5111.031 Action against noninstitutional medicaid provider.
5111.032 Criminal records check of provider personnel.
5111.033 Criminal records checks by waiver agencies.
5111.034 Fingerprint impressions and criminal records check independent provider in department administered home and community-based waiver program.
5111.04 Outpatient health facilities.
5111.041 [Repealed].
5111.042 Recipient with developmental disability who is eligible for medicaid case management services.
5111.05 Contracts for examination, processing, and determination of medical assistance claims.
5111.06 Adjudication orders of department.
5111.061 Recovery of medicaid overpayments.
5111.062 Hearing not required unless timely requested.
5111.07 Determining maximum dispensing fee.
5111.071 Dispensing fee.
5111.08 Outpatient drug use review program.
5111.081 Supplemental drug rebate program.
5111.082 State maximum allowable cost program.
5111.083 E-prescribing system.
5111.084 Pharmacy and therapeutics committee.
5111.085 Transferred to 5111.084.
5111.09 Annual report.
5111.091 Quarterly reports on controlling increase in costs.
5111.092 Annual report outlining efforts to minimize medicaid fraud, waste, and abuse.
5111.10 Review of medicaid program - corrective action - sanctions.
5111.101 Information required where annual medicaid payments exceed $5 million.
5111.102 No state cause of action to enforce federal laws.
5111.11 Estate recovery program.
5111.111 Lien against property of recipient or spouse as part of estate recovery program.
5111.112 Certification of amounts due under estate recovery program - collection.
5111.113 Transfer of personal needs allowance account.
5111.114 Deducting personal needs allowance from recipient's income.
5111.12 Recovering benefits incorrectly paid.
5111.121 Recovering health care costs provided to child.
5111.13 Enrolling in group health plan.
5111.14 Case management of nonemergency transportation services.
5111.15 Beneficiary of disability trust.
5111.151 Eligibility determinations for cases involving medical assistance provided pursuant to this chapter.
5111.16 Care management system.
5111.161 [Repealed].
5111.162 Reference by managed care organization to noncontracting participant.
5111.163 Payment of nonsystem provider for emergency services.
5111.17 Managed care system.
5111.171 Financial incentive awards - health care compliance fund.
5111.172 Requiring coverage of prescription drugs for medicaid recipients.
5111.173 Appointment of temporary manager.
5111.174 Disenrolling some or all medicaid recipients enrolled in managed care organization under contract.
5111.175 Records for determining costs.
5111.176 Medicaid health insuring corporation franchise permit fee - managed care assessment fund.
5111.177 Health insuring corporation contract to provide grievance process.
5111.178 Application for federal medicaid requirements waiver.
5111.18 Qualified long-term care insurance partnership program.
5111.181 Life insurance policies.
5111.19 Reimbursement of graduate medical education costs.
5111.191 Payment for graduate medical education costs to noncontracting hospitals.
5111.20 Nursing facilities and intermediate care facilities for mentally retarded definitions.
5111.201 Nursing facility references.
5111.202 Admission of mentally ill person to nursing facility.
5111.203 Hearing.
5111.204 Assessment to determine level of care.
5111.205 [Repealed].
5111.21 [Effective Until 9/17/2010] Paying reasonable costs of services provided by eligible facility.
5111.211 Responsibility for nonfederal share of claims submitted for services.
5111.22 Provider agreement requirements.
5111.221 Calculating rates and making payments.
5111.222 Calculation of payments to nursing facility providers.
5111.223 Facility operator may contract with more than one provider.
5111.23 Paying per resident per day rate for direct care costs.
5111.231 Per resident per day rate for direct care costs.
5111.232 Case-mix scores for nursing facilities.
5111.233 Day programming.
5111.235 Per resident per day rate for other protected costs.
5111.236 Oxygen services for "medically fragile child".
5111.24 Per resident per day rate for ancillary and support costs.
5111.241 Per resident per day rate for indirect care costs - intermediate care facility.
5111.242 Per resident per day rate for tax costs.
5111.243 Per resident per day rate for franchise permit fees.
5111.244 Quality incentive payment for qualifying nursing facilities.
5111.25 Per resident per day rate for reasonable capital costs.
5111.251 Per resident per day rate for reasonable capital costs - intermediate care facility.
5111.252 Amended and Renumbered RC 5123.199.
5111.254 Initial rates for nursing facility with first licensure date after June 30, 2006.
5111.255 Initial rates for intermediate care facility for mentally retarded with first licensure date after June 30, 2006.
5111.257 Rate for added, replaced, or renovated beds.
5111.258 Calculating prospective rates for facilities with residents whose care costs are not otherwise adequately measured.
5111.26 Annual cost report.
5111.261 Limiting compensation of owners, their relatives, administrators, and resident meals outside facility.
5111.262 Claim for medicaid reimbursement for service provided to nursing facility resident.
5111.263 [Repealed].
5111.264 Related party costs to pass through.
5111.265 Cost of operating rights for relocated beds not allowable cost.
5111.266 Cost of franchise permit fee not reimbursable expense.
5111.27 Desk review of cost report.
5111.28 Refund of certain payments by operators.
5111.29 Reconsideration of rate.
5111.291 Computing rate for intermediate care facilities.
5111.30 Termination for non-compliance with installation of fire extinguishing and fire alarm systems.
5111.31 Provider agreement to prohibit certain discriminatory actions.
5111.32 Action against facility for breach of provider agreement or other duties.
5111.33 Reserving bed during temporary absence of resident.
5111.34 Report recommending methodology to transition paying providers.
5111.341 [Repealed].
5111.35 Nursing facility deficiency definitions.
5111.36 Adoption of rules.
5111.37 Enforcement of rules.
5111.38 Contracts with state agencies for enforcement.
5111.39 Annual standard surveys.
5111.40 Exit interview with administrator.
5111.41 Citations for failure to comply with one or more certification requirements.
5111.411 Survey results.
5111.42 Statement of deficiencies.
5111.43 Plan of correction.
5111.44 On-site monitoring.
5111.45 Deficiencies not substantially corrected.
5111.46 Uncorrected deficiencies constituting severity level four findings.
5111.47 Uncorrected deficiencies constituting severity level three and scope level three or four findings.
5111.48 Uncorrected deficiencies constituting severity level one or two or severity level three, scope level two finding.
5111.49 Imposing remedies and fines.
5111.50 Fine collected if termination order does not take effect.
5111.51 Emergency remedies.
5111.52 Terminating provider agreements.
5111.53 Transfer of residents to other appropriate care settings.
5111.54 Qualifications of temporary manager of nursing facility.
5111.55 Residents to whom denial of medicaid payments applies.
5111.56 Fines.
5111.57 Order denying payment when deficiency is not corrected within time limits.
5111.58 Termination of participation for failure to correct deficiency within six months.
5111.59 Delivery of notices.
5111.60 Appeals.
5111.61 Confidentiality.
5111.62 Residents protection fund.
5111.63 Hearing on transfer or discharge of resident who medicaid or medicare beneficiary.
5111.65 [Effective Until 8/31/2010] Notice of facility closure, etc. - definitions.
5111.651 [Effective Until 8/31/2010] Application of notice provisions.
5111.66 Notice of facility closure, termination, or withdrawal of participation.
5111.661 Compliance with Social Security Act required.
5111.67 Operator notice of intent to continue participation.
5111.671 Provider agreement with entering operator.
5111.672 Effective date of provider agreement with entering operator.
5111.673 Entering operator duties under provider agreement.
5111.674 Exiting operator deemed operator pending change.
5111.675 Provider agreement with operator not complying with prior agreement.
5111.676 Medicaid reimbursement adjustments - change of operator.
5111.677 Determination of change of operator - excluded factors.
5111.68 [Effective Until 8/31/2010] Overpayment amounts determined following notice of closure, etc.
5111.681 [Effective Until 8/31/2010] Withholding from medicaid payment due exiting operator.
5111.682 Cost report by exiting operator - waiver.
5111.683 Failure to file cost report - payments deemed overpayments.
5111.684 Final payment withheld pending receipt of cost reports.
5111.685 [Effective Until 8/31/2010] Determination of debt of exiting operator - summary report.
5111.686 [Effective Until 8/31/2010] Release of amount withheld less amounts owed.
5111.687 Release of amount withheld on postponement of change of operator.
5111.688 [Repealed Effective 8/31/2010] Rules prescribing medicaid reimbursement methodology.
5111.689 [Effective 8/31/2010] Rules prescribing medicaid reimbursement methodology.
5111.70 Medicaid buy-in for workers with disabilities program.
5111.701 Qualifications for assistance under program.
5111.702 Resource eligibility limit - annual adjustment.
5111.703 Individual income eligibility limit.
5111.704 Amount of annual individual premium.
5111.705 Eligibility not denied due to RC 5111.851 services.
5111.706 Continued participation where employment ceases.
5111.707 Director to make federally required amendments.
5111.708 Program implementing rules - disregarded income.
5111.709 Medicaid buy-in advisory council.
5111.7010 Consultation with advisory council.
5111.7011 Annual program report - distribution - contents.
5111.71 Plan amendment for medicaid school component.
5111.711 Claim by qualified medicaid school provider.
5111.712 Federal financial participation for medicaid school claims.
5111.713 Administration of medicaid school component.
5111.714 Medicaid school program administrative fund.
5111.715 Implementing rules for medicaid school component.
5111.74 [Repealed].
5111.75 [Repealed].
5111.76 [Repealed].
5111.77, 5111.771 [Repealed].
5111.78 to 5111.80 [Repealed].
5111.81 Amended and Renumbered to RC 5111.085.
5111.811 [Repealed].
5111.82 [Repealed].
5111.84 Notice of intent to request medicaid waiver.
5111.85 Medicaid waiver components.
5111.851 Home and community-based services medicaid waiver components.
5111.852 Review of plans of care and individual service plans.
5111.853 Agency records of costs of medicaid waiver components.
5111.854 Agency accountable for medicaid waiver components funds.
5111.855 Agency contracting for medicaid waiver components - assurance of compliance.
5111.856 Transfer of enrollee in one medicaid waiver component to another.
5111.86 Creation of medicaid home and community-based services programs to replace former programs.
5111.861 Consolidated federal medicaid waiver.
5111.87 Medicaid waivers.
5111.871 Alternative to intermediate care facility for mentally retarded.
5111.872 Allocating enrollment numbers to county board of developmental disabilities.
5111.873 Statewide fee schedules for home and community-based services provided under component of the medicaid program.
5111.874 [Effective Until 8/31/2010] Conversion of beds to home and community-based services.
5111.875 [Effective Until 8/31/2010] Conversion of beds in acquired intermediate care facility.
5111.876 Request for federal approval of conversion of beds.
5111.877 Maximum number of beds approved.
5111.878 Maximum number of beds converted.
5111.879 Reconversion of beds to ICF/MR use.
5111.8710 Implementing rules for conversion of beds.
5111.88 Federal medicaid waivers authorizing components covering home care attendant services.
5111.881 Home care attendant services providers.
5111.882 Continuing education requirements for home care attendants.
5111.883 Responsibilities of home care attendants.
5111.884 Nursing assistance by home care attendants.
5111.885 Nursing assistance by home care attendants - consent and authorization.
5111.886 Nursing assistance by home care attendants - writtent statement providing consent.
5111.887 Nursing assistance by home care attendants - written statement of authorization.
5111.888 Nursing assistance by home care attendants - unauthorized actions.
5111.889 Practice of nursing as registered nurse or licensed practical nurse not allowed by home care attendants.
5111.8810 Authorized representative.
5111.8811 Adoption of rules under section 5111.85.
5111.8812 [Repealed].
5111.8813 [Repealed].
5111.8814 [Repealed].
5111.8815 [Repealed].
5111.8816 [Repealed].
5111.8817 [Repealed].
5111.89 Request to HHS for waiver regarding assisted living program.
5111.891 Eligibility for assisted living program.
5111.892 Staff requirements for assisted living program facility.
5111.893 Contract for evaluation of program cost-effectiveness.
5111.894 [Effective Until 8/31/2010] Assisted living waiting lists - notice of admission - eligibility.
5111.90 Contracts with political subdivisions to pay nonfederal share.
5111.91 Contracts for administration of components.
5111.911 Contract approval required.
5111.912 Department of mental health payment of nonfederal share of medicaid payment.
5111.913 Department of alcohol and drug addiction services payment of nonfederal share of medicaid payment.
5111.914 Agency action to recover overpayment to provider.
5111.915 Contract for data collection and warehouse functions assessment.
5111.92 Retaining or collecting percentage of federal financial participation.
5111.93 Retaining or collecting percentage of supplemental payment.
5111.94 Health care services administration fund.
5111.941 Medicaid revenue and collections fund.
5111.942 Prescription drug rebates fund.
5111.943 Health care-federal fund.
5111.95 Amended and Renumbered RC 5111.033.
5111.96 Amended and Renumbered RC 5111.034.
5111.97 Ohio access success project.
5111.971 Request to HHS for waiver regarding health care services.
5111.98 Powers of director regarding Medicare Prescription Act of 2003.
5111.99 Penalty.

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