Ohio Chapter 5164 — Medicaid State Plan Services

92 sections hosted, reproduced from the official public-domain source.

Ohio Rev. Code Ann. § 5164.01— Definitions
Ohio Rev. Code Ann. § 5164.02— Rules to implement chapter
Ohio Rev. Code Ann. § 5164.03— Mandatory and optional services
Ohio Rev. Code Ann. § 5164.06— Medicaid coverage of occupational therapy services
Ohio Rev. Code Ann. § 5164.07— Coverage of inpatient care and follow-up care for a mother and her newborn
Ohio Rev. Code Ann. § 5164.08— Breast cancer and cervical cancer screening
Ohio Rev. Code Ann. § 5164.09— Equivalent coverage for orally and intravenously administered cancer medications
Ohio Rev. Code Ann. § 5164.10— Coverage of tobacco cessation medications and services
Ohio Rev. Code Ann. § 5164.14— Medicaid coverage for health care service provided by pharmacist
Ohio Rev. Code Ann. § 5164.15— Mental health services
Ohio Rev. Code Ann. § 5164.16— Coverage of one or more state plan home and community-based services
Ohio Rev. Code Ann. § 5164.17— Medicaid coverage of tobacco cessation services
Ohio Rev. Code Ann. § 5164.20— Medicaid not to cover drugs for erectile dysfunction
Ohio Rev. Code Ann. § 5164.25— Recipient with developmental disability who is eligible for medicaid case management services
Ohio Rev. Code Ann. § 5164.26— Healthcheck component
Ohio Rev. Code Ann. § 5164.29— Revised Medicaid provider enrollment system
Ohio Rev. Code Ann. § 5164.30— Provider agreement with department required
Ohio Rev. Code Ann. § 5164.31— Funding for implementing the provider screening requirements
Ohio Rev. Code Ann. § 5164.32— Expiration of medicaid provider agreements
Ohio Rev. Code Ann. § 5164.33— Denying, terminating, and suspending provider agreements
Ohio Rev. Code Ann. § 5164.34— Criminal records check of provider personnel, owners and officers
Ohio Rev. Code Ann. § 5164.35— Provider offenses
Ohio Rev. Code Ann. § 5164.36— Credible allegation of fraud or disqualifying indictment; suspension of provider agreement
Ohio Rev. Code Ann. § 5164.37— Suspension of provider agreement without notice
Ohio Rev. Code Ann. § 5164.38— Adjudication orders of department
Ohio Rev. Code Ann. § 5164.39— Hearing not required unless timely requested
Ohio Rev. Code Ann. § 5164.44— Employee status of independent provider
Ohio Rev. Code Ann. § 5164.45— Contracts for examination, processing, and determination of medicaid claims
Ohio Rev. Code Ann. § 5164.46— Electronic claims submission process; electronic fund transfers
Ohio Rev. Code Ann. § 5164.47— Contracting for review and analysis, quality assurance and quality review
Ohio Rev. Code Ann. § 5164.48— Medicaid payments made to organization on behalf of providers
Ohio Rev. Code Ann. § 5164.55— Final fiscal audits
Ohio Rev. Code Ann. § 5164.56— Lien for amount owed by provider
Ohio Rev. Code Ann. § 5164.57— Recovery of medicaid overpayments
Ohio Rev. Code Ann. § 5164.58— Agency action to recover overpayment to provider
Ohio Rev. Code Ann. § 5164.59— Deduction of incorrect payments
Ohio Rev. Code Ann. § 5164.60— Interest on Medicaid provider excess payments
Ohio Rev. Code Ann. § 5164.061— Chiropractic services
Ohio Rev. Code Ann. § 5164.61— Scope of available remedies for recovery of excess payments
Ohio Rev. Code Ann. § 5164.70— Limitations on medicaid payments for services
Ohio Rev. Code Ann. § 5164.071— Doula program
Ohio Rev. Code Ann. § 5164.71— Payments for freestanding medical laboratory charges
Ohio Rev. Code Ann. § 5164.072— Coverage of donor breast milk and fortifiers
Ohio Rev. Code Ann. § 5164.72— Limitations on payments for inpatient hospital care
Ohio Rev. Code Ann. § 5164.73— Division of payments between physician or podiatrist and nurse
Ohio Rev. Code Ann. § 5164.74— Reimbursement of graduate medical education costs
Ohio Rev. Code Ann. § 5164.75— Medicaid payment for a drug subject to a federal upper reimbursement limit
Ohio Rev. Code Ann. § 5164.76— Manner of payment for community mental health service providers or facilities and alcohol and drug addiction services
Ohio Rev. Code Ann. § 5164.78— Medicaid payment rates for certain neonatal and newborn services
Ohio Rev. Code Ann. § 5164.80— Public notice for changes to payment rates for medicaid assistance
Ohio Rev. Code Ann. § 5164.82— Payment for provider-preventable condition
Ohio Rev. Code Ann. § 5164.85— Enrolling in group health plan
Ohio Rev. Code Ann. § 5164.86— Qualified state long-term care insurance partnership program
Ohio Rev. Code Ann. § 5164.88— Coordinated care through health homes
Ohio Rev. Code Ann. § 5164.89— Case management of nonemergency transportation services
Ohio Rev. Code Ann. § 5164.90— Transition of medicaid recipients to community settings
Ohio Rev. Code Ann. § 5164.091— Coverage for opioid analgesics
Ohio Rev. Code Ann. § 5164.91— Integrated care delivery system
Ohio Rev. Code Ann. § 5164.092— Coverage of remote ultrasounds and fetal nonstress tests
Ohio Rev. Code Ann. § 5164.92— Advanced diagnostic imaging services coverage under medicaid program
Ohio Rev. Code Ann. § 5164.093— Coverage of rapid whole genome sequencing
Ohio Rev. Code Ann. § 5164.93— Incentive payments for adoption and use of electronic health record technology
Ohio Rev. Code Ann. § 5164.94— Delivery of services in culturally and linguistically appropriate manners
Ohio Rev. Code Ann. § 5164.95— Standards for payments for telehealth services; eligible practitioners
Ohio Rev. Code Ann. § 5164.96— Ground emergency medical transportation supplemental payment program
Ohio Rev. Code Ann. § 5164.291— Provider credentialing committee
Ohio Rev. Code Ann. § 5164.301— Medicaid provider agreements for physician assistants
Ohio Rev. Code Ann. § 5164.341— Criminal records check by independent provider
Ohio Rev. Code Ann. § 5164.342— Criminal records checks by waiver agencies
Ohio Rev. Code Ann. § 5164.471— Summary data regarding perinatal services
Ohio Rev. Code Ann. § 5164.721— Claims by freestanding birthing centers
Ohio Rev. Code Ann. § 5164.741— Payment for graduate medical education costs to noncontracting hospitals
Ohio Rev. Code Ann. § 5164.751— State maximum allowable cost program
Ohio Rev. Code Ann. § 5164.752— Determining maximum dispensing fee
Ohio Rev. Code Ann. § 5164.753— Dispensing fee
Ohio Rev. Code Ann. § 5164.754— Agreement for multiple-state drug purchasing program
Ohio Rev. Code Ann. § 5164.755— Supplemental drug rebate program
Ohio Rev. Code Ann. § 5164.756— Drug rebate agreement or supplemental drug rebate agreement for medicaid program not subject to public records law
Ohio Rev. Code Ann. § 5164.757— E-prescribing applications
Ohio Rev. Code Ann. § 5164.758— Adoption of rules for implementation of coordinated services program for medicaid users who abuse prescription drugs
Ohio Rev. Code Ann. § 5164.759— Outpatient drug use review program
Ohio Rev. Code Ann. § 5164.761— Beta testing of updates to billing codes or payment rates
Ohio Rev. Code Ann. § 5164.881— Health home services
Ohio Rev. Code Ann. § 5164.911— Integrated care delivery system evaluation
Ohio Rev. Code Ann. § 5164.912— Integrated care delivery system standardized claim form
Ohio Rev. Code Ann. § 5164.913— Home health aide and personal care aide training
Ohio Rev. Code Ann. § 5164.951— Standards for medicaid payments for services provided through teledentistry
Ohio Rev. Code Ann. § 5164.7510— Pharmacy and therapeutics committee
Ohio Rev. Code Ann. § 5164.7511— Medication synchronization for medicaid recipients
Ohio Rev. Code Ann. § 5164.7512— Definitions for sections 5164.7512 to 5164.7514
Ohio Rev. Code Ann. § 5164.7514— Step therapy exemption process
Ohio Rev. Code Ann. § 5164.7515— Annual benchmark for prescribed drug spending growth