Section 5164.91 | Integrated Care Delivery System.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly The medicaid director may implement a demonstration project called the integrated care delivery system to test and evaluate the integration of the care that dual eligible individuals receive under medicare and medicaid. No provision of Title LI of the Revised Code applies […]
Section 5164.78 | Medicaid Payment Rates for Certain Neonatal and Newborn Services.
Effective: November 22, 2017 Latest Legislation: House Bill 49 – 132nd General Assembly (A) The medicaid payment rates for the following neonatal and newborn services shall equal seventy-five per cent of the medicare payment rates for the services in effect on the date the services are provided to medicaid recipients eligible for the services: (1) […]
Section 5164.80 | Public Notice for Changes to Payment Rates for Medicaid Assistance.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly As necessary to comply with the “Social Security Act,” section 1902(a)(13)(A), 42 U.S.C. 1396a(a)(13)(A), and any other federal law that requires public notice of proposed changes to payment rates for medicaid services, the medicaid director shall give public notice in the register […]
Section 5164.82 | Payment for Provider-Preventable Condition.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly The department of medicaid shall not knowingly make a medicaid payment for a provider-preventable condition for which federal financial participation is prohibited by regulations adopted under the “Patient Protection and Affordable Care Act,” section 2702, 42 U.S.C. 1396b-1.
Section 5164.85 | Enrolling in Group Health Plan.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) As used in this section, “cost-effective” and “group health plan” have the same meanings as in the “Social Security Act,” section 1906, 42 U.S.C. 1396e, and any regulations adopted under that section. (B) The department of medicaid may implement a program […]
Section 5164.86 | Qualified State Long-Term Care Insurance Partnership Program.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly The medicaid director shall establish a qualified state long-term care insurance partnership program consistent with the definition of that term in the “Social Security Act,” section 1917(b)(1)(C)(iii), 42 U.S.C. 1396p(b)(1)(C)(iii). An individual participating in the program who is subject to the medicaid […]
Section 5164.88 | Coordinated Care Through Health Homes.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly The medicaid director may implement within the medicaid program a system under which medicaid recipients with chronic conditions are provided with coordinated care through health homes, as authorized by the “Social Security Act,” section 1945, 42 U.S.C. 1396w-4.
Section 5164.757 | E-Prescribing Applications.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) As used in this section, “licensed health professional authorized to prescribe drugs” has the same meaning as in section 4729.01 of the Revised Code. (B) The medicaid director may acquire or specify technologies to provide information regarding medicaid recipient eligibility, claims […]
Section 5164.758 | Adoption of Rules for Implementation of Coordinated Services Program for Medicaid Users Who Abuse Prescription Drugs.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly The medicaid director shall adopt rules under section 5164.02 of the Revised Code to implement a coordinated services program for medicaid recipients who are found to have obtained prescribed drugs under the medicaid program at a frequency or in an amount that […]
Section 5164.759 | Outpatient Drug Use Review Program.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly In accordance with the “Social Security Act,” section 1927(g), 42 U.S.C. 1396r-8(g), the department of medicaid shall establish an outpatient drug use review program to assure that prescriptions obtained by medicaid recipients are appropriate, medically necessary, and unlikely to cause adverse medical […]