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 5164.881 | Health Home Services.
Effective: October 12, 2016 Latest Legislation: House Bill 158 – 131st General Assembly The medicaid director, in consultation with the director of developmental disabilities, may develop and implement within the medicaid program a system under which eligible individuals with chronic conditions, as defined in the “Social Security Act,” section 1945 (h)(1), 42 U.S.C. 1396w-4(h)(1), who […]
Section 5164.89 | Case Management of Nonemergency Transportation Services.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly The department of medicaid may require county departments of job and family services to provide case management of nonemergency transportation services provided under the medicaid program. County departments shall provide the case management if required by the department in accordance with rules […]
Section 5164.90 | Transition of Medicaid Recipients to Community Settings.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) As used in this section, “MFP demonstration project” means a money follows the person demonstration project that the United States secretary of health and human services is authorized to award under section 6071 of the “Deficit Reduction Act of 2005” (Pub. […]
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 5164.7511 | Medication Synchronization for Medicaid Recipients.
Effective: March 22, 2020 Latest Legislation: Senate Bill 229 – 132nd General Assembly (A) As used in this section: (1) “Cost-sharing” means any cost-sharing requirements instituted for the medicaid program under section 5162.20 of the Revised Code. (2) “Medication synchronization” means a pharmacy service that synchronizes the filling or refilling of prescriptions in a manner […]
Section 5164.7512 | Definitions for Sections 5164.7512 to 5164.7514.
Effective: April 5, 2019 Latest Legislation: Senate Bill 265 – 132nd General Assembly (A) As used in sections 5164.7512 to 5164.7514 of the Revised Code: (1) “Clinical practice guidelines” means a systematically developed statement to assist providers and medicaid recipients in making decisions about appropriate health care for specific clinical circumstances and conditions. (2) “Clinical […]
Section 5164.7514 | Step Therapy Exemption Process.
Effective: April 5, 2019 Latest Legislation: Senate Bill 265 – 132nd General Assembly (A) All of the following shall apply to the step therapy exemption process established and implemented by the department of medicaid pursuant to division (B)(2) of section 5164.7512 of the Revised Code: (1) The process shall be clear and convenient. (2) The […]