5111.211 Responsibility for nonfederal share of claims submitted for services.
(A) Except as provided in division (C) of this section, the department of developmental disabilities is responsible for the nonfederal share of claims submitted for services that are covered by the medicaid program and provided to an eligible medicaid recipient by an intermediate care facility for the mentally retarded if all of the following are the case:
(1) The services are provided on or after July 1, 2003;
(2) The facility receives initial certification by the director of health as an intermediate care facility for the mentally retarded on or after June 1, 2003;
(3) The facility, or a portion of the facility, is licensed by the director of developmental disabilities as a residential facility under section 5123.19 of the Revised Code;
(4) There is a valid provider agreement for the facility.
(B) Each month, the department of job and family services shall invoice the department of developmental disabilities by interagency transfer voucher for the claims for which the department of developmental disabilities is responsible pursuant to this section.
(C)Division (A) of this section does not apply to claims submitted for an intermediate care facility for the mentally retarded if, under section 5123.193 or 5123.197 of the Revised Code, a residential facility license was obtained or modified for the facility without obtaining approval of a plan for the proposed residential facility pursuant to section 5123.042 of the Revised Code.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
Amended by 128th General Assembly ch. 7, SB 79, § 1, eff. 10/6/2009.
5111.211 Responsibility for nonfederal share of claims submitted for services.
(A) Except as provided in division (C) of this section, the department of developmental disabilities is responsible for the nonfederal share of claims submitted for services that are covered by the medicaid program and provided to an eligible medicaid recipient by an intermediate care facility for the mentally retarded if all of the following are the case:
(1) The services are provided on or after July 1, 2003;
(2) The facility receives initial certification by the director of health as an intermediate care facility for the mentally retarded on or after June 1, 2003;
(3) The facility, or a portion of the facility, is licensed by the director of developmental disabilities as a residential facility under section 5123.19 of the Revised Code;
(4) There is a valid provider agreement for the facility.
(B) Each month, the department of job and family services shall invoice the department of developmental disabilities by interagency transfer voucher for the claims for which the department of developmental disabilities is responsible pursuant to this section.
(C)Division (A) of this section does not apply to claims submitted for an intermediate care facility for the mentally retarded if, under section 5123.193 or 5123.197 of the Revised Code, a residential facility license was obtained or modified for the facility without obtaining approval of a plan for the proposed residential facility pursuant to section 5123.042 of the Revised Code.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
Amended by 128th General Assembly ch. 7, SB 79, § 1, eff. 10/6/2009.
5111.211 Responsibility for nonfederal share of claims submitted for services.
(A) Except as provided in division (C) of this section, the department of developmental disabilities is responsible for the nonfederal share of claims submitted for services that are covered by the medicaid program and provided to an eligible medicaid recipient by an intermediate care facility for the mentally retarded if all of the following are the case:
(1) The services are provided on or after July 1, 2003;
(2) The facility receives initial certification by the director of health as an intermediate care facility for the mentally retarded on or after June 1, 2003;
(3) The facility, or a portion of the facility, is licensed by the director of developmental disabilities as a residential facility under section 5123.19 of the Revised Code;
(4) There is a valid provider agreement for the facility.
(B) Each month, the department of job and family services shall invoice the department of developmental disabilities by interagency transfer voucher for the claims for which the department of developmental disabilities is responsible pursuant to this section.
(C)Division (A) of this section does not apply to claims submitted for an intermediate care facility for the mentally retarded if, under section 5123.193 or 5123.197 of the Revised Code, a residential facility license was obtained or modified for the facility without obtaining approval of a plan for the proposed residential facility pursuant to section 5123.042 of the Revised Code.
Amended by 128th General Assembly File No. 9, HB 1, § 101.01, eff. 10/16/2009.
Amended by 128th General Assembly ch. 7, SB 79, § 1, eff. 10/6/2009.
