Ohio Chapter 5167 — Medicaid Managed Care

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

Ohio Rev. Code Ann. § 5167.01— Definitions
Ohio Rev. Code Ann. § 5167.02— Rules
Ohio Rev. Code Ann. § 5167.03— Care management system
Ohio Rev. Code Ann. § 5167.04— Inclusion of alcohol, drug addiction, and mental health services in care management system
Ohio Rev. Code Ann. § 5167.05— Inclusion of prescribed drugs in care management system
Ohio Rev. Code Ann. § 5167.09— Managed care financial dashboard information
Ohio Rev. Code Ann. § 5167.10— Authority to contract with managed care orgainizations
Ohio Rev. Code Ann. § 5167.11— Managed care organization contract to provide grievance process
Ohio Rev. Code Ann. § 5167.12— Requirements when prescribed drugs are included in care management system
Ohio Rev. Code Ann. § 5167.13— Implementation of coordinated services program for enrollees who abuse prescribed drugs
Ohio Rev. Code Ann. § 5167.14— Data security agreements for managed care organization's use of drug database
Ohio Rev. Code Ann. § 5167.15— Chiropractic services
Ohio Rev. Code Ann. § 5167.16— Home visits and cognitive behavioral therapy
Ohio Rev. Code Ann. § 5167.17— Enhanced care management services for pregnant women and women capable of becoming pregnant
Ohio Rev. Code Ann. § 5167.18— Identification of fraud, waste, and abuse
Ohio Rev. Code Ann. § 5167.20— Reference by managed care organization to noncontracting participant
Ohio Rev. Code Ann. § 5167.21— Payments to skilled nursing facility
Ohio Rev. Code Ann. § 5167.22— Recoupment of overpayment
Ohio Rev. Code Ann. § 5167.24— Third-party administrator as single pharmacy benefit manager
Ohio Rev. Code Ann. § 5167.26— Records for determining costs
Ohio Rev. Code Ann. § 5167.30— Managed care performance payment program
Ohio Rev. Code Ann. § 5167.031— Recognition of pediatric accountable care organizations
Ohio Rev. Code Ann. § 5167.31— Financial incentive awards
Ohio Rev. Code Ann. § 5167.32— Improving integrity of care management system
Ohio Rev. Code Ann. § 5167.33— Strategies regarding payment to providers
Ohio Rev. Code Ann. § 5167.34— Immunity from liability
Ohio Rev. Code Ann. § 5167.35— Meaningful employment of Medicaid recipients
Ohio Rev. Code Ann. § 5167.40— Appointment of temporary manager
Ohio Rev. Code Ann. § 5167.41— Disenrolling some or all medicaid recipients from MCO plan offered by a managed care organization
Ohio Rev. Code Ann. § 5167.45— Information about medicaid recipients' races, ethnicities, and primary languages
Ohio Rev. Code Ann. § 5167.47— Compliance with federal mental health and addiction parity laws
Ohio Rev. Code Ann. § 5167.051— Coverage of services provided by pharmacist
Ohio Rev. Code Ann. § 5167.101— Basis of hospital inpatient capital payment portion of payment to medicaid managed care organization
Ohio Rev. Code Ann. § 5167.103— Performance metrics; publication
Ohio Rev. Code Ann. § 5167.122— Disclosure of sources of payment
Ohio Rev. Code Ann. § 5167.123— Medicaid MCO contracts with 340B program participants
Ohio Rev. Code Ann. § 5167.171— Uniform prior approval form for progesterone
Ohio Rev. Code Ann. § 5167.173— Community health worker services or services provided by public health nurse
Ohio Rev. Code Ann. § 5167.201— Payment of nonsystem provider for emergency services
Ohio Rev. Code Ann. § 5167.221— Assessment of recoupment efforts
Ohio Rev. Code Ann. § 5167.241— State pharmacy benefit manager contract; payment arrangements
Ohio Rev. Code Ann. § 5167.243— Quarterly reports
Ohio Rev. Code Ann. § 5167.244— Violations; penalty
Ohio Rev. Code Ann. § 5167.245— Appeals process