Section 5162.16 | Reporting Fraud, Waste, or Abuse.
Effective: September 29, 2017 Latest Legislation: House Bill 49 – 132nd General Assembly A government entity that administers one or more components of the medicaid program and has reasonable cause to believe that an instance of fraud, waste, or abuse has occurred in the medicaid program shall inform the department of medicaid. The department shall […]
Section 5162.20 | Cost-Sharing Requirements.
Effective: September 18, 2020 Latest Legislation: House Bill 11 – 133rd General Assembly (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 does either of the following: (1) Disproportionately impacts the ability of medicaid recipients with chronic illnesses to obtain […]
Section 5162.06 | Components Requiring Federal Approval or Funding.
Effective: June 13, 2022 Latest Legislation: House Bill 136 – 134th General Assembly (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 […]
Section 5162.07 | Federal Approval for Permissive Components Not Required.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly 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 […]
Section 5162.10 | Review of Medicaid Program; Corrective Action; Sanctions.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly 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 […]
Section 5162.11 | Contract for Data Collection and Warehouse Functions Assessment.
Effective: September 29, 2015 Latest Legislation: House Bill 64 – 131st General Assembly (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 […]
Section 5162.12 | Contracts for the Management of Medicaid Data Requests.
Effective: October 17, 2019 Latest Legislation: House Bill 166 – 133rd General Assembly (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 […]
Section 5162.13 | Annual Report.
Effective: April 6, 2017 Latest Legislation: Senate Bill 332 – 131st General Assembly (A) On or before the first day of January of each year, the department of medicaid shall complete a report on the effectiveness of the medicaid program in meeting the health care needs of low-income pregnant women, infants, and children. The report […]
Section 5162.131 | Semiannual Reports on Controlling Increase in Costs.
Effective: March 20, 2014 Latest Legislation: Senate Bill 206 – 130th General Assembly Semiannually, the medicaid director shall complete a report on the establishment and implementation of programs designed to control the increase of the cost of the medicaid program, increase the efficiency of the medicaid program, and promote better health outcomes. The director shall […]
Section 5162.031 | Powers of Director.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) The medicaid director may do all of the following as necessary for the department of medicaid to fulfill the duties it has, as the single state agency for the medicaid program, under the “Medicare Prescription Drug, Improvement, and Modernization Act of […]