Ohio Revised Code Chapter 5162 - Medicaid And Medicaid Funds

• Section 5162.01 - Definitions.
  (A) As used in the Revised Code: (1) "Medicaid" and "medicaid program" mean the program of medical assistance established by Title XIX of the...
• Section 5162.02 - Rules For Implementation Of Chapter.
  The medicaid director shall adopt rules as necessary to implement this chapter. Added by 130th General Assembly File No. 25, HB 59, §101.01, eff.
• Section 5162.021 - Adoption Of Rules By Other State Agencies.
  The medicaid director shall adopt rules under sections 5160.02, 5162.02, 5163.03, 5164.04, 5165.05, 5166.02, and 5167.02 of the Revised Code as necessary to authorize...
• Section 5162.022 - Director's Rules Binding.
  The medicaid director's rules governing medicaid are binding on other state agencies and political subdivisions that administer one or more components of the medicaid...
• Section 5162.03 - [Renumbered From 5111.01] Administration Of Medicaid Program.
  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...
• Section 5162.031 - [Renumbered From 5111.98] Powers Of Director.
  (A) The medicaid director may do all of the following as necessary for the department of medicaid to fulfill the duties it has, as...
• Section 5162.04 - [Renumbered From 5111.102] No State Cause Of Action To Enforce Federal Laws.
  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...
• Section 5162.05 - Implementation Of Medicaid Program.
  The medicaid program shall be implemented in accordance with all of the following: (A) The medicaid state plan approved by the United States secretary...
• Section 5162.06 - Components Requiring Federal Approval Or Funding.
  (A) Notwithstanding any other state statute, no component, or aspect of a component, of the medicaid program shall be implemented without all of the...
• Section 5162.07 - Federal Approval For Permissive Components Not Required.
  The medicaid director shall seek federal approval for all components, and aspects of components, of the medicaid program for which federal approval is needed,...
• Section 5162.10 - [Renumbered From 5111.10] Review Of Medicaid Program; Corrective Action; Sanctions.
  The medicaid director may conduct reviews of the medicaid program. The reviews may include physical inspections of records and sites where medicaid services are...
• Section 5162.11 - [Renumbered From 5111.915] Contract For Data Collection And Warehouse Functions Assessment.
  (A) The department of medicaid shall enter into an agreement with the department of administrative services for the department of administrative services to contract...
• Section 5162.12 - Contracts For The Management Of Medicaid Data Requests.
  (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...
• Section 5162.13 - [Renumbered From 5111.09] Annual Report.
  (A) On or before the first day of January of each year, the department of medicaid shall complete a report on the effectiveness of...
• Section 5162.131 - [Renumbered From 5111.091] Semiannual Reports On Controlling Increase In Costs.
  Semiannually, the medicaid director shall complete a report on the establishment and implementation of programs designed to control the increase of the cost of...
• Section 5162.132 - [Renumbered From 5111.092] Annual Report Outlining Efforts To Minimize Fraud, Waste, And Abuse.
  Annually, the department of medicaid shall prepare a report on the department's efforts to minimize fraud, waste, and abuse in the medicaid program. Each...
• Section 5162.133 - [Renumbered From 5163.0910] Annual Program Report; Distribution; Contents.
  Not less than once each year, the medicaid director shall submit a report on the medicaid buy-in for workers with disabilities program to the...
• Section 5162.134 - Annual Report Of Integrated Care Delivery System Evaluation.
  Not later than the first day of each July, the medicaid director shall complete a report of the evaluation conducted under section 5164.911 of...
• Section 5162.15 - [Renumbered From 5111.101] Information Required Where Annual Medicaid Payments Exceed $5 Million.
  (A) As used in this section; "Agent" and "contractor" include any agent, contractor, subcontractor, or other person who, on behalf of an entity, furnishes...
• Section 5162.20 - Cost-sharing Requirements.
  (A) The department of medicaid shall institute cost-sharing requirements for the medicaid program. The department shall not institute cost-sharing requirements in a manner that...
• Section 5162.21 - [Renumbered From 5111.11] Medicaid Estate Recovery Program.
  (A) As used in this section and section 5162.211 of the Revised Code: (1) "Estate" includes both of the following: (a) All real and...
• Section 5162.211 - [Renumbered From 5111.111] Lien Against Property Of Recipient Or Spouse As Part Of Estate Recovery Program.
  (A) Except as provided in division (B) of this section and section 5162.23 of the Revised Code, no lien may be imposed against the...
• Section 5162.212 - [Renumbered From 5111.112] Certification Of Amounts Due Under Estate Recovery Program; Collection.
  The department of medicaid shall certify amounts due under the medicaid estate recovery program instituted under section 5162.21 of the Revised Code to the...
• Section 5162.22 - [Renumbered From 5111.113] Transfer Of Personal Needs Allowance Account.
  (A) As used in this section: (1) "Commissioner" means a person appointed by a probate court under division (E) of section 2113.03 of the...
• Section 5162.23 - [Renumbered From 5111.12] Recovering Benefits Incorrectly Paid.
  (A) The medicaid director shall adopt rules under section 5162.02 of the Revised Code permitting county departments of job and family services to take...
• Section 5162.24 - [Renumbered From 5111.121] Recovering Health Care Costs Provided To Child.
  (A) As used in this section, "third party" has the same meaning as in section 5160.35 of the Revised Code. (B) In addition to...
• Section 5162.30 - [Renumbered From 5111.83] Medicaid Administrative Claiming Program.
  (A) The medicaid director shall create a medicaid administrative claiming program under which federal financial participation is received for the administrative costs incurred by...
• Section 5162.31 - Local Funds Expended For Administration Of The Healthy Start Component.
  Local funds, whether from public or private sources, expended by a county department of job and family services for administration of the healthy start...
• Section 5162.32 - [Renumbered From 5111.90] Contracts With Political Subdivisions To Pay Nonfederal Share.
  The department of medicaid may enter into contracts with political subdivisions to use funds of the political subdivision to pay the nonfederal share of...
• Section 5162.35 - [Renumbered From 5111.91] Contracts For Administration Of Components.
  The department of medicaid may enter into contracts with one or more other state agencies or political subdivisions to have the state agency or...
• Section 5162.36 - [Renumbered From 5111.71] Medicaid School Component.
  The medicaid director shall create, in accordance with sections 5162.36 to 5162.365 of the Revised Code, the medicaid school component of the medicaid program....
• Section 5162.361 - [Renumbered From 5111.711] Claim By Qualified Medicaid School Provider.
  A qualified medicaid school provider participating in the medicaid school component of the medicaid program may submit a claim to the department of medicaid...
• Section 5162.362 - [Renumbered From 5111.712] Federal Financial Participation For Medicaid School Claims.
  The department of medicaid shall seek federal financial participation for each claim a qualified medicaid school provider properly submits to the department under section...
• Section 5162.363 - [Renumbered From 5111.713] Administration Of Medicaid School Component.
  The department of medicaid shall enter into an interagency agreement with the department of education under section 5162.35 of the Revised Code that provides...
• Section 5162.364 - [Renumbered From 5111.715] Adoption Of Rules For Medicaid School Component.
  The medicaid director shall adopt rules under section 5162.02 of the Revised Code as necessary to implement the medicaid school component of the medicaid...
• Section 5162.365 - Responsibility For Repaying Overpayments.
  (A) A qualified medicaid school provider is solely responsible for timely repaying any overpayment that the provider receives under the medicaid school component of...
• Section 5162.37 - [Renumbered From 5111.911] Contract Approval Required.
  Any contract the department of medicaid enters into with the department of mental health and addiction services under section 5162.35 of the Revised Code...
• Section 5162.371 - [Renumbered From 5111.912] Contracts With Department Of Mental Health And Addiction Services; Payment Of Nonfederal Share Of Medicaid Payment.
  If the department of medicaid enters into a contract with the department of mental health and addiction services under section 5162.35 of the Revised...
• Section 5162.40 - [Renumbered From 5111.92] Retaining Or Collecting Percentage Of Federal Financial Participation.
  (A) (1) Except as provided in division (B) of this section, if a state agency or political subdivision administers one or more components of...
• Section 5162.41 - [Renumbered From 5111.93] Retaining Or Collecting Percentage Of Supplemental Payment.
  The department of medicaid may retain or collect a percentage of the federal financial participation included in a supplemental medicaid payment to one or...
• Section 5162.50 - [Renumbered From 5111.943] Health Care-federal Fund.
  (A) The health care - federal fund is hereby created in the state treasury. All of the following shall be credited to the fund:...
• Section 5162.52 - [Renumbered From 5111.941] Health Care/medicaid Support And Recoveries Fund.
  (A) The health care/medicaid support and recoveries fund is hereby created in the state treasury. All of the following shall be credited to the...
• Section 5162.54 - [Renumbered From 5111.94] Health Care Services Administration Fund.
  (A) There is hereby created in the state treasury the health care services administration fund. Except as provided in division (C) of this section,...
• Section 5162.56 - [Renumbered From 5111.945] Health Care Special Activities Fund.
  There is created in the state treasury the health care special activities fund. The department of medicaid shall deposit all funds it receives pursuant...
• Section 5162.58 - [Renumbered From 5111.944] Integrated Care Delivery Systems Fund.
  There is created in the state treasury the integrated care delivery systems fund. If the terms of the federal approval for the dual eligible...
• Section 5162.60 - Managed Care Performance Payment Fund.
  (A) There is hereby created in the state treasury the managed care performance payment fund. The fund shall consist of all of the following:...
• Section 5162.62 - Medicaid Administrative Reimbursement Fund.
  There is hereby created in the state treasury the medicaid administrative reimbursement fund. The department of medicaid shall use money in the fund to...
• Section 5162.64 - [Renumbered From 5111.714] Medicaid School Program Administrative Fund.
  (A) There is hereby created in the state treasury the medicaid school program administrative fund. (B) Both of the following shall be deposited into...
• Section 5162.66 - [Renumbered From 5111.62] Residents Protection Fund.
  As used in this section, "deficiency" has the same meaning as in section 5165.60 of the Revised Code. The proceeds of all fines, including...
• Section 5162.70 - Reforms To Medicaid Program.
  (A) As used in this section: (1) "CPI" means the consumer price index for all urban consumers as published by the United States bureau...
• Section 5162.71 - Implementation Of Systems To Improve Health And Reduce Health Disparities.
  The medicaid director shall implement within the medicaid program systems that do both of the following: (A) Improve the health of medicaid recipients through...
• Section 5162.80 - [Effective 1/1/2017] Good Faith Estimates For Charges And Payments.
  (A) A provider of medical services licensed, accredited, or certified under Chapter 3721., 3727., 4715., 4725., 4731., 4732., 4734., 4747., 4753., 4755., 4757., or...

Last modified: October 10, 2016