Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly No person or government entity may participate in the medicaid program as a medicaid provider without a valid provider agreement with the department of medicaid.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) As used in this section, “group practice” has the same meaning as in section 4731.65 of the Revised Code. (B) The department of medicaid shall establish a process by which a physician assistant may enter into a provider agreement. (C)(1) Subject […]
Effective: September 29, 2017 Latest Legislation: House Bill 49 – 132nd General Assembly (A) For the purpose of raising funds necessary to pay the expenses of implementing the provider screening requirements of subpart E of 42 C.F.R. Part 455 and except as provided in division (B) of this section, the department of medicaid shall collect […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) Each medicaid provider agreement shall expire not later than five years from its effective date. If a provider agreement entered into before the effective date of this amendment does not have a time limit, the department of medicaid shall convert the […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) The medicaid director may do the following for any reason permitted or required by federal law and when the director determines that the action is in the best interests of medicaid recipients or the state: (1) Deny, refuse to revalidate, suspend, […]
Effective: September 30, 2021 Latest Legislation: House Bill 110 – 134th General Assembly (A) As used in this section: (1) “Criminal records check” has the same meaning as in section 109.572 of the Revised Code. (2) “Disqualifying offense” means any of the offenses listed or described in divisions (A)(3)(a) to (e) of section 109.572 of […]
Effective: September 29, 2017 Latest Legislation: House Bill 49 – 132nd General Assembly (A) As used in this section: “Anniversary date” means the later of the effective date of the provider agreement relating to the independent provider or sixty days after September 26, 2003. “Applicant” means a person who has applied for a provider agreement […]
Effective: September 30, 2021 Latest Legislation: House Bill 110 – 134th General Assembly (A) As used in this section: “Applicant” means a person who is under final consideration for employment with a waiver agency in a full-time, part-time, or temporary position that involves providing home and community-based services. “Community-based long-term care provider” means a provider […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) As used in this section, “owner” means any person having at least five per cent ownership in a medicaid provider. (B)(1) No medicaid provider shall do any of the following: (a) By deception, obtain or attempt to obtain payments under the […]
Effective: October 17, 2019 Latest Legislation: House Bill 166 – 133rd General Assembly (A) As used in this section: (1) “Credible allegation of fraud” has the same meaning as in42 C.F.R. 455.2, except that for purposes of this section any reference in that regulation to the “state” or the “state medicaid agency” means the department […]
Effective: October 17, 2019 Latest Legislation: House Bill 166 – 133rd General Assembly (A) The department of medicaid may suspend a medicaid provider’s provider agreement without prior notice if the department has evidence that the provider presents a danger of immediate and serious harm to the health, safety, or welfare of medicaid recipients. The department […]
Effective: October 17, 2019 Latest Legislation: House Bill 166 – 133rd General Assembly (A) As used in this section: (1) “Party” has the same meaning as in division (G) of section 119.01 of the Revised Code. (2) “Revalidate” means to approve a medicaid provider’s continued enrollment as a medicaid provider in accordance with the revalidation […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly In any action taken by the department of medicaid under section 5164.38 or 5164.57 of the Revised Code or any other state statute governing the medicaid program that requires the department to give notice of an opportunity for a hearing in accordance […]
Effective: March 23, 2016 Latest Legislation: House Bill 56 – 131st General Assembly (A) As used in this section: (1) “Aide services” means all of the following: (a) Home health aide services covered by the medicaid program as part of the home health services benefit pursuant to 42 C.F.R. 440.70(b)(2); (b) Home care attendant services […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) The department of medicaid may contract with any person or persons as a fiscal agent for the examination, processing, and determination of medicaid claims. The contracting party may provide any of the following services, as required by the contract: (1) Design […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) As used in this section, “electronic claims submission process” means any of the following: (1) Electronic interchange of data; (2) Direct entry of data through an internet-based mechanism implemented by the department of medicaid; (3) Any other process for the electronic […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) As used in this section, “OCHSPS” means the private, not-for-profit corporation known as the Ohio children’s hospital solutions for patient safety, which was formed for the purpose of improving pediatric patient care in this state, which performs functions that are included […]
Effective: April 6, 2017 Latest Legislation: Senate Bill 332 – 131st General Assembly Not less than once each year and in accordance with all state and federal laws governing the confidentiality of patient-identifying information, the department of medicaid shall make summary data regarding perinatal services available on request to local organizations concerned with infant mortality […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly The medicaid director may implement a system under which medicaid payments for medicaid services are made to an organization on behalf of medicaid providers. The system may not provide for an organization to receive an amount that exceeds, in aggregate, the amount […]
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly The department of medicaid may conduct final fiscal audits of medicaid providers in accordance with the applicable requirements set forth in federal laws and regulations and determine any amounts the provider may owe the state. When conducting final fiscal audits, the department […]
