Chapter 5111 MEDICAL ASSISTANCE PROGRAMS
- 5111.01 [Renumbered as5162.03]
- 5111.011 [Renumbered as5163.02]
- 5111.012 [Repealed]
- 5111.013 [Renumbered as5163.40]
- 5111.014 [Repealed]
- 5111.015 [Repealed]
- 5111.016 [Renumbered as5164.26]
- 5111.017 [Repealed]
- 5111.018 [Renumbered as5164.07]
- 5111.019 [Renumbered as 5111.0120]
- 5111.0110 [Repealed]
- 5111.0111 [Repealed]
- 5111.0112 [Renumbered as5162.20]
- 5111.0113 [Repealed]
- 5111.0114 [Renumbered as5164.754]
- 5111.0115 [Repealed]
- 5111.0116 [Renumbered as5163.30]
- 5111.0117 [Renumbered as5163.31]
- 5111.0118 [Renumbered as5163.32]
- 5111.0119 [Renumbered as5163.45]
- 5111.0120 [Repealed]
- 5111.0121 [Repealed]
- 5111.0122 [Repealed]
- 5111.0123 [Repealed]
- 5111.0124 [Renumbered as5163.10]
- 5111.0125 [Renumbered as5163.101] Medicaid state plan amendment; qualified entities for purposes of the presumptive eligibility for children option
- 5111.02 [Renumbered as5164.02] Rules establishing amount, duration and scope of services
- 5111.021 [Renumbered as5164.70] Reimbursement of providers
- 5111.022 [Renumbered as5164.56] Lien for amount owed by provider
- 5111.023 [Renumbered as5164.15] Mental health services
- 5111.024 [Renumbered as5164.08]
- 5111.025 [Renumbered as5164.76] Manner of payment for community mental health facilities and alcohol and drug addiction services
- 5111.027 [Renumbered as5164.20] Medicaid not to cover drugs for erectile dysfunction
- 5111.028 [Renumbered as5164.32] Time-limited medicaid provider agreements
- 5111.029 [Renumbered as5164.06] Medicaid coverage of occupational therapy services
- 5111.0210 [Renumbered as5164.92] Advanced diagnostic imaging services availability under medicaid program
- 5111.0211 [Renumbered as5165.48] Nursing facility not required to submit Medicaid claim for Medicare cost-sharing expenses under certain circumstances
- 5111.0212 [Renumbered as5164.80] Public notice for changes to medicaid reimbursement rate for medical assistance
- 5111.0213 [Renumbered as5164.77] Adjustment of medicaid payments; payment for aide or nursing services
- 5111.0214 [Renumbered as5164.82] Payment for provider-preventable condition
- 5111.0215 [Renumbered as5164.93] Incentive payments for adoption and use of electronic health record technology
- 5111.03 [Renumbered as5164.35] Provider offenses
- 5111.031 [Renumbered as5164.37]
- 5111.032 [Renumbered as5164.34]
- 5111.033 [Renumbered as5164.342]
- 5111.034 [Renumbered as5164.341]
- 5111.035 [Renumbered as5164.36]
- 5111.04 [Renumbered as5164.05] Outpatient health facilities
- 5111.041 [Repealed]
- 5111.042 [Renumbered as5164.25] Recipient with developmental disability who is eligible for medicaid case management services
- 5111.05 [Renumbered as5164.45] Contracts for examination, processing, and determination of medical assistance claims
- 5111.051 [Renumbered as5164.48] Medical assistance payments made to organization on behalf of providers
- 5111.052 [Renumbered as5164.46] Electronic claims submission process; electronic fund transfers
- 5111.053 [Renumbered as5164.301] Medicaid provider agreements for physician assistants
- 5111.054 [Renumbered as5164.47] Contracting for review and analysis, quality assurance and quality review
- 5111.06 [Renumbered as5164.38] Adjudication orders of department
- 5111.061 [Renumbered as5164.57] Recovery of medicaid overpayments
- 5111.062 [Renumbered as5164.39] Hearing not required unless timely requested
- 5111.063 [Renumbered as5164.31] Funding for implementing the provider screening requirements
- 5111.07 [Renumbered as5164.752] Determining maximum dispensing fee
- 5111.071 [Renumbered as5164.753] Dispensing fee
- 5111.08 [Renumbered as5164.759] Outpatient drug use review program
- 5111.081 [Renumbered as5164.755] Supplemental drug rebate program
- 5111.082 [Renumbered as5164.751] State maximum allowable cost program
- 5111.083 [Renumbered as5164.757] E-prescribing system
- 5111.084 [Renumbered as5164.7510] Pharmacy and therapeutics committee
- 5111.085 [Renumbered as5164.758] Adoption of rules for implementation of coordinated services program for medicaid users who abuse prescription drugs
- 5111.086 [Renumbered as5164.75] Medicaid payment for a drug subject to a federal upper reimbursement limit
- 5111.09 [Renumbered as5162.13] Annual report
- 5111.091 [Renumbered as5162.131] Quarterly reports on controlling increase in costs
- 5111.092 [Renumbered as5162.132] Annual report outlining efforts to minimize medicaid fraud, waste, and abuse
- 5111.10 [Renumbered as5162.10] Review of medicaid program - corrective action - sanctions
- 5111.101 [Renumbered as5162.15] Information required where annual medicaid payments exceed $5 million
- 5111.102 [Renumbered as5162.04] No state cause of action to enforce federal laws
- 5111.11 [Renumbered as5162.21] Estate recovery program
- 5111.111 [Renumbered as5162.211] Lien against property of recipient or spouse as part of estate recovery program
- 5111.112 [Renumbered as5162.212] Certification of amounts due under estate recovery program - collection
- 5111.113 [Renumbered as5162.22] Transfer of personal needs allowance account
- 5111.114 [Renumbered as5163.33] Deducting personal needs allowance from recipient's income
- 5111.12 [Renumbered as5162.23] Recovering benefits incorrectly paid
- 5111.121 [Renumbered as5162.24] Recovering health care costs provided to child
- 5111.13 [Renumbered as5164.85] Enrolling in group health plan
- 5111.14 [Renumbered as5164.88] Coordinated care through health homes
- 5111.141 [Renumbered as5164.89] Case management of nonemergency transportation services
- 5111.15 [Renumbered as5163.20] Beneficiary of disability trust
- 5111.151 [Renumbered as5163.21] Eligibility determinations for cases involving medicaid programs
- 5111.16 [Renumbered as5167.03] Care management system
- 5111.161 [Renumbered as5167.031] Recognition of pediatric accountable care organizations
- 5111.162 [Renumbered as5167.20] Reference by managed care organization to noncontracting participant
- 5111.163 [Renumbered as5167.201] Payment of nonsystem provider for emergency services
- 5111.17 [Renumbered as5167.10] Managed care system
- 5111.171 [Renumbered as5167.31] Financial incentive awards
- 5111.172 [Renumbered as5167.12] Requiring coverage of prescription drugs for medicaid recipients
- 5111.173 [Renumbered as5167.40] Appointment of temporary manager
- 5111.174 [Renumbered as5167.41] Disenrolling some or all medicaid recipients enrolled in managed care organization under contract
- 5111.175 [Renumbered as5167.26] Records for determining costs
- 5111.176 [Repealed]
- 5111.177 [Renumbered as5167.11] Health insuring corporation contract to provide grievance process
- 5111.178 [Renumbered as5167.25] Application for federal medicaid requirements waiver
- 5111.179 [Renumbered as5167.13] Contracts with managed care organizations; Implementation of coordinated services program for medicaid recipients who abuse prescription drugs
- 5111.1710 [Renumbered as5167.14] Security agreements for managed care organization's use of drug database
- 5111.1711 [Renumbered as5167.30] Managed care performance payment program
- 5111.18 [Renumbered as5164.86] Qualified long-term care insurance partnership program
- 5111.181 [Renumbered as5163.22] Life insurance policies
- 5111.19 [Renumbered as5164.74] Reimbursement of graduate medical education costs
- 5111.191 [Renumbered as5164.741] Payment for graduate medical education costs to noncontracting hospitals
- 5111.20 [Renumbered as5165.01] Definitions
- 5111.201 [Renumbered as5165.011] Nursing facility references
- 5111.202 [Renumbered as5165.03] Admission of mentally ill person to nursing facility
- 5111.203 [Renumbered as5165.031] Hearing
- 5111.204 [Renumbered as5165.04] Assessment to determine level of care
- 5111.205 [Repealed]
- 5111.21 [Renumbered as5165.06] Paying reasonable costs of services provided by eligible facility
- 5111.211 [Repealed]
- 5111.212 [Renumbered as5165.35] Payments made to facility for services provided after involuntary termination
- 5111.22 [Renumbered as5165.07] Provider agreement requirements
- 5111.221 [Renumbered as5165.37] Calculating rates and making payments
- 5111.222 [Renumbered as5165.15] Calculation of payments to nursing facility providers; quality bonus
- 5111.223 [Renumbered as5165.071] Facility operator may contract with more than one provider
- 5111.224 [Renumbered as5124.15] Amount of payments to intermediate care facility pursuant to provider agreement
- 5111.225 [Renumbered as5165.155] Amount of payments for dual eligible individuals
- 5111.226 [Renumbered as5124.02] Assumption of powers and duties regarding medicaid program's coverage of services provided by intermediate care facilities
- 5111.23 [Renumbered as5124.19] Paying per resident per day rate for direct care costs
- 5111.231 [Renumbered as5165.19] Per resident per day rate for direct care costs
- 5111.232 [Renumbered as5165.192] Case-mix scores for nursing facilities
- 5111.233 [Renumbered as5124.194] Day programming
- 5111.235 [Renumbered as5124.23] Per resident per day rate for other protected costs
- 5111.236 [Repealed]
- 5111.24 [Renumbered as5165.16] Per resident per day rate for ancillary and support costs
- 5111.241 [Renumbered as5124.21] Per resident per day rate for indirect care costs - intermediate care facility
- 5111.242 [Renumbered as5165.21] Per resident per day rate for tax costs
- 5111.243 [Repealed]
- 5111.244 [Renumbered as5165.25] Quality incentive payments for qualifying nursing facilities
- 5111.245 [Renumbered as5165.26] Payment of quality bonus
- 5111.246 [Renumbered as5165.23] Critical access incentive payments to qualified facilities
- 5111.25 [Renumbered as5165.17] Per resident per day rate for reasonable capital costs
- 5111.251 [Renumbered as5124.17] Per resident per day rate for reasonable capital costs - intermediate care facility
- 5111.252 Amended and Renumbered RC 5123.199
- 5111.254 [Renumbered as5165.151] Initial rates for nursing facility with first licensure date after June 30, 2006
- 5111.255 [Renumbered as5124.151] Initial rates for intermediate care facility
- 5111.257 [Renumbered as5165.28] Rate for added, replaced, or renovated beds
- 5111.258 [Renumbered as5165.153] Calculating prospective rates for facilities with residents whose care costs are not otherwise adequately measured
- 5111.259 [Renumbered as5165.156] Centers of excellence component
- 5111.26 [Renumbered as5165.10] Annual cost report
- 5111.261 [Renumbered as5165.107] Amendments to cost reports
- 5111.262 [Renumbered as5165.47] Claim for medicaid reimbursement for service provided to nursing facility resident
- 5111.263 [Renumbered as5124.29] Limiting compensation of owners, their relatives, administrators, and resident meals outside facility
- 5111.264 [Renumbered as5165.30] Related party costs to pass through
- 5111.265 [Renumbered as5165.29] Cost of operating rights for relocated beds not allowable cost
- 5111.266 [Renumbered as5165.101] Cost of franchise permit fee not reimbursable expense
- 5111.27 [Renumbered as5165.108] Desk review of cost report
- 5111.271 [Renumbered as5165.1010] Nursing facility fines
- 5111.28 [Renumbered as5165.40] Refund of certain payments by operators
- 5111.29 [Renumbered as5165.38] Reconsideration of rate
- 5111.291 [Renumbered as5124.154] Computing rate for intermediate care facilities
- 5111.30 [Renumbered as5165.073] Termination for non-compliance with installation of fire extinguishing and fire alarm systems
- 5111.31 [Renumbered as5165.08] Provider agreement to prohibit certain discriminatory actions
- 5111.32 [Renumbered as5165.081] Action against facility for breach of provider agreement or other duties
- 5111.33 [Renumbered as5124.34] Reserving bed during temporary absence of resident
- 5111.331 [Renumbered as5165.34] Payments made to reserve bed during temporary absence
- 5111.34 [Repealed]
- 5111.341 [Repealed]
- 5111.35 [Renumbered as5165.60] Nursing facility deficiency definitions
- 5111.36 [Renumbered as5165.61] Adoption of rules
- 5111.37 [Renumbered as5165.62] Enforcement of rules
- 5111.38 [Renumbered as5165.63] Contracts with state agencies for enforcement
- 5111.39 [Renumbered as5165.64] Annual standard surveys
- 5111.40 [Renumbered as5165.65] Exit interview with administrator
- 5111.41 [Renumbered as5165.66] Citations for failure to comply with one or more certification requirements
- 5111.411 [Renumbered as5165.67] Survey results
- 5111.42 [Renumbered as5165.68] Statement of deficiencies
- 5111.43 [Renumbered as5165.69] Plan of correction
- 5111.44 [Renumbered as5165.70] On-site monitoring
- 5111.45 [Renumbered as5165.71] Deficiencies not substantially corrected
- 5111.46 [Renumbered as5165.72] Uncorrected deficiencies constituting severity level four findings
- 5111.47 [Renumbered as5165.73] Uncorrected deficiencies constituting severity level three and scope level three or four findings
- 5111.48 [Renumbered as5165.74] Uncorrected deficiencies constituting severity level one or two or severity level three, scope level two finding
- 5111.49 [Renumbered as5165.75] Imposing remedies and fines
- 5111.50 [Renumbered as5165.76] Fine collected if termination order does not take effect
- 5111.51 [Renumbered as5165.77] Emergency remedies
- 5111.511 [Renumbered as5165.78] Appointment of temporary resident safety assurance manager
- 5111.52 [Renumbered as5165.79] Terminating provider agreements
- 5111.53 [Renumbered as5165.80] Transfer of residents to other appropriate care settings
- 5111.54 [Renumbered as5165.81] Qualifications of temporary manager of nursing facility
- 5111.55 [Renumbered as5165.82] Residents to whom denial of medicaid payments applies
- 5111.56 [Renumbered as5165.83] Fines
- 5111.57 [Renumbered as5165.84] Order denying payment when deficiency is not corrected within time limits
- 5111.58 [Renumbered as5165.85] Termination of participation for failure to correct deficiency within six months
- 5111.59 [Renumbered as5165.86] Delivery of notices
- 5111.60 [Renumbered as5165.87] Appeals
- 5111.61 [Renumbered as5165.88] Confidentiality
- 5111.62 [Renumbered as5162.66] Residents protection fund
- 5111.63 [Renumbered as5165.89] Hearing on transfer or discharge of resident who medicaid or medicare beneficiary
- 5111.65 [Repealed]
- 5111.651 [Repealed]
- 5111.66 [Renumbered as5165.50] Notice of facility closure, termination, or withdrawal of participation
- 5111.661 [Renumbered as5165.501] Compliance with Social Security Act required
- 5111.67 [Renumbered as5165.51] Operator notice of intent to continue participation
- 5111.671 [Renumbered as5165.511] Provider agreement with entering operator
- 5111.672 [Renumbered as5165.512] Effective date of provider agreement with entering operator
- 5111.673 [Renumbered as5165.513] Entering operator duties under provider agreement
- 5111.674 [Renumbered as5165.514] Exiting operator deemed operator pending change
- 5111.675 [Renumbered as5165.515] Provider agreement with operator not complying with prior agreement
- 5111.676 [Renumbered as5165.516] Medicaid reimbursement adjustments - change of operator
- 5111.677 [Renumbered as5165.517] Determination of change of operator - excluded factors
- 5111.68 [Renumbered as5165.52] Overpayment amounts determined following notice of closure, etc
- 5111.681 [Renumbered as5165.521] Withholding from medicaid payment due exiting operator
- 5111.682 [Renumbered as5165.522] Cost report by exiting operator - waiver
- 5111.683 [Renumbered as5165.523] Failure to file cost report - payments deemed overpayments
- 5111.684 [Renumbered as5165.524] Final payment withheld pending receipt of cost reports
- 5111.685 [Renumbered as5165.525] Determination of debt of exiting operator - summary report
- 5111.686 [Renumbered as5165.526] Release of amount withheld less amounts owed
- 5111.687 [Renumbered as5165.527] Release of amount withheld on postponement of change of operator
- 5111.688 [Renumbered as5165.528] Disposition of amounts withheld from payment due an exiting operator
- 5111.689 [Renumbered as5165.53] Adoption of rules
- 5111.70 [Renumbered as5163.09] Medicaid buy-in for workers with disabilities program
- 5111.701 [Renumbered as5163.091] Qualifications for assistance under program
- 5111.702 [Renumbered as5163.092] Resource eligibility limit - annual adjustment
- 5111.703 [Renumbered as5163.093] Individual income eligibility limit
- 5111.704 [Renumbered as5163.094] Amount of annual individual premium
- 5111.705 [Renumbered as5163.095] Eligibility not denied due to RC 5111.851 services
- 5111.706 [Renumbered as5163.096] Continued participation where employment ceases
- 5111.707 [Renumbered as5163.097] Director to make federally required amendments
- 5111.708 [Renumbered as5163.098] Program implementing rules - disregarded income
- 5111.709 [Renumbered as5163.099] Medicaid buy-in advisory council
- 5111.7010 [Repealed]
- 5111.7011 [Renumbered as5163.0910] Annual program report - distribution - contents
- 5111.71 [Renumbered as5162.36] Plan amendment for medicaid school component
- 5111.711 [Renumbered as5162.361] Claim by qualified medicaid school provider
- 5111.712 [Renumbered as5162.362] Federal financial participation for medicaid school claims
- 5111.713 [Renumbered as5162.363] Administration of medicaid school component
- 5111.714 [Renumbered as5162.64] Medicaid school program administrative fund
- 5111.715 [Renumbered as5162.364] Implementing rules for medicaid school component
- 5111.74 [Repealed]
- 5111.75 [Repealed]
- 5111.76 [Repealed]
- 5111.77, 5111.771 [Repealed]
- 5111.78 to 5111.80 [Repealed]
- 5111.81 Amended and Renumbered to RC 5111.085
- 5111.811 [Repealed]
- 5111.82 [Repealed]
- 5111.83 [Renumbered as5162.30] Application for reimbursement under medicaid administrative claiming program
- 5111.84 [Renumbered as5166.03] Notice of intent to request medicaid waiver
- 5111.85 [Renumbered as5166.02] Medicaid waiver components
- 5111.851 [Renumbered as5166.04] Home and community-based services medicaid waiver components
- 5111.852 [Renumbered as5166.05] Review of plans of care and individual service plans
- 5111.853 [Renumbered as5166.06] Agency records of costs of medicaid waiver components
- 5111.854 [Renumbered as5166.07] Agency accountable for medicaid waiver components funds
- 5111.855 [Renumbered as5166.08] Agency contracting for medicaid waiver components - assurance of compliance
- 5111.856 [Renumbered as5166.10] Transfer of enrollee in one medicaid waiver component to another
- 5111.86 [Renumbered as5166.11] Creation of medicaid home and community-based services programs to replace former programs
- 5111.861 [Renumbered as5166.12] Ohio home care program
- 5111.862 [Renumbered as5166.121] Home first component for the Ohio home care program
- 5111.863 [Renumbered as5166.13] Ohio transitions II aging carve-out program
- 5111.864 [Renumbered as5166.14] Unified long-term services and support medicaid waiver component
- 5111.865 [Renumbered as5166.141] Home first component for unified long-term services and support medicaid waiver program
- 5111.87 [Renumbered as5166.20] Medicaid waivers
- 5111.871 [Renumbered as5166.21] Alternative to intermediate care facility for developmentally disabled
- 5111.872 [Renumbered as5166.22] Allocating enrollment numbers to county board of developmental disabilities
- 5111.873 [Renumbered as5166.23] Reimbursement for home and community-based services provided under component of the medicaid program
- 5111.874 [Renumbered as5124.60] Conversion of beds to home and community-based services
- 5111.875 [Renumbered as5124.61] Conversion of beds in acquired intermediate care facility
- 5111.876 [Renumbered as5124.62] Request for federal approval of conversion of beds
- 5111.877 [Renumbered as5124.63] Maximum number of beds approved
- 5111.878 [Renumbered as5124.64] Maximum number of beds converted
- 5111.879 [Renumbered as5124.65] Reconversion of beds to ICF/MR use
- 5111.8710 [Repealed]
- 5111.88 [Renumbered as5166.30] Federal medicaid waivers authorizing components covering home care attendant services
- 5111.881 [Renumbered as5166.301] Home care attendant services providers
- 5111.882 [Renumbered as5166.302] Continuing education requirements for home care attendants
- 5111.883 [Renumbered as5166.303] Responsibilities of home care attendants
- 5111.884 [Renumbered as5166.304] Nursing assistance by home care attendants
- 5111.885 [Renumbered as5166.305] Nursing assistance by home care attendants - consent and authorization
- 5111.886 [Renumbered as5166.306]
- 5111.887 [Renumbered as5166.307] Nursing assistance by home care attendants - written statement of authorization
- 5111.888 [Renumbered as5166.308] Nursing assistance by home care attendants - unauthorized actions
- 5111.889 [Renumbered as5166.309] Practice of nursing as registered nurse or licensed practical nurse not allowed by home care attendants
- 5111.8810 [Renumbered as5166.3010] Authorized representative
- 5111.8811 [Repealed]
- 5111.8812 [Repealed]
- 5111.8813 [Repealed]
- 5111.8814 [Repealed]
- 5111.8815 [Repealed]
- 5111.8816 [Repealed]
- 5111.8817 [Repealed]
- 5111.89 [Renumbered as173.54] Assisted living program
- 5111.891 [Renumbered as173.541] Eligibility for assisted living program
- 5111.892 [Renumbered as173.544] Eligibility requirements for state-funded component of assisted living program
- 5111.893 [Renumbered as173.547] Staff requirements for assisted living program facility
- 5111.894 [Renumbered as173.542] Home first component of the assisted living program
- 5111.90 [Renumbered as5162.32] Contracts with political subdivisions to pay nonfederal share
- 5111.91 [Renumbered as5162.35] Contracts for administration of components
- 5111.911 [Renumbered as5162.37] Contract approval required
- 5111.912 [Renumbered as5162.371] Department of mental health payment of nonfederal share of medicaid payment
- 5111.913 [Repealed]
- 5111.914 [Renumbered as5164.58] Agency action to recover overpayment to provider
- 5111.915 [Renumbered as5162.11] Contract for data collection and warehouse functions assessment
- 5111.92 [Renumbered as5162.40] Retaining or collecting percentage of federal financial participation
- 5111.93 [Renumbered as5162.41] Retaining or collecting percentage of supplemental payment
- 5111.94 [Renumbered as5162.54] Health care services administration fund
- 5111.941 [Renumbered as5162.52] Health care/medicaid support and recoveries fund
- 5111.942 [Repealed]
- 5111.943 [Renumbered as5162.50] Health care-federal fund
- 5111.944 [Renumbered as5162.58] Integrated care delivery systems fund
- 5111.945 [Renumbered as5162.56] Health care special activities fund
- 5111.946 [Repealed]
- 5111.95 Amended and Renumbered RC 5111.033
- 5111.96 [Renumbered as5164.90] Transition of medicaid recipients to community settings
- 5111.97 [Renumbered as5166.35] Ohio access success project
- 5111.971 [Repealed]
- 5111.98 [Renumbered as5162.031] Powers of director regarding Medicare Prescription Act of 2003
- 5111.981 [Renumbered as5164.91] Demonstration project to evaluate integration of care dual eligible individuals receive
- 5111.982 [Renumbered as5167.21]
- 5111.99 [Renumbered as5165.99] Penalty