Research About Meet PRIA

Support Data Sources Privacy Policy Terms of Servicehello@policyrisk.com

© 2026 PRIA Technologies, LLC. All rights reserved.

PRIA provides educational policy intelligence and is not a source of investment, legal, or financial advice. Content is for informational purposes only.

™

Your Policy Risk Impact Agent

Research

At My Address
Federal Courts
Daily Briefings
Medicare & Social Security
Policy Risk Index
Congressional Bills
Federal Register
Tariffs
Fed Decisions & The Economy
State Tracker
World Watch
U.S. Code
U.S. Constitution
Aliens

Knowledge

Search Polipedia
Daily Briefings
Calculators
Policy Risk Index
What is Policy Risk?
The Countdown

Company

About PRIA
Support

Get PRIA

Support Data Sources Privacy Policy Terms of Service

hello@policyrisk.com

© 2026 PRIA Technologies, LLC. All rights reserved.

PRIA is a trademark of PRIA Technologies, LLC.

PRIA provides educational policy intelligence and is not a source of investment, legal, or financial advice. Content is for informational purposes only.

Ohio Statutes, Title 51

™

Your Policy Risk Impact Agent

Ohio/Statutes

← All Ohio coverage

Title 51, Title 51. Public Welfare

31 chapters · 1,983 sections in this title.

All chapters in Title 511,983 Ch 5123, Chapter 5123 | Department of Develop…182 Ch 5101, Chapter 5101 | Department of Job and…144 Ch 5119, Chapter 5119 | Department of Behavio…121 Ch 5120, Chapter 5120 | Department of Rehabil…121 Ch 5165, Chapter 5165 | Medicaid Coverage of …116 Ch 5103, Chapter 5103 | Placement of Children113 Ch 5126, Chapter 5126 | County Boards of Deve…111 Ch 5180, Chapter 5180 | Department of Childre…94 Ch 5164, Chapter 5164 | Medicaid State Plan S…92 Ch 5124, Chapter 5124 | Intermediate Care Fac…80 Ch 5153, Chapter 5153 | County Children Services72 Ch 5104, Chapter 5104 | Child Day-care69 Ch 5168, Chapter 5168 | Hospital Care Assuran…66 Ch 5107, Chapter 5107 | Ohio Works First Program64

1,983 sections·Filtered byTitle 51✕

Ohio Rev. Code Ann. § 5165.156 Centers of excellence component
1.1K chars
The medicaid director may establish a centers of excellence component of the medicaid program. The purpose of the centers of excellence component is to increase the efficiency and quality of nursing facility services provided to medicaid recipients with complex nursing facility s…
Ohio Rev. Code Ann. § 5165.157 Alternative purchasing model for nursing facility services
4.7K chars
(A) As used in this section, "SFF list" and "CMS" have the same meanings as in section 5165.26 of the Revised Code. (B) The medicaid director shall establish an alternative purchasing model for nursing facility services provided by designated discrete units of nursing facilities …
Ohio Rev. Code Ann. § 5165.158 Private room incentive payment
5.7K chars
(A) As used in this section: (1) "Category one private room" means a private room that has unshared access to a toilet and sink. (2) "Category two private room" means a private room that has shared access to a toilet and sink. (B) Beginning six months following approval by the Un…
Ohio Rev. Code Ann. § 5165.16 Per medicaid day payment rate for ancillary and support costs; peer groups
4.4K chars

Showing 1,651–1,700 of 1,983

Page 34 of 40

← Previous Next →

(A) The department of medicaid shall determine each nursing facility's per medicaid day payment rate for ancillary and support costs. A nursing facility's rate shall be the rate determined under division (C) of this section for the nursing facility's peer group. (B) For the purpo…

Ohio Rev. Code Ann. § 5165.17 Per medicaid day payment rate for reasonable capital costs

16.1K chars

(A) The department of medicaid shall determine each nursing facility's per medicaid day payment rate for capital costs. A nursing facility's rate shall be the rate determined under division (C) of this section for the nursing facility's peer group. (B) For the purpose of determin…

Ohio Rev. Code Ann. § 5165.19 Per medicaid day payment rate for direct care costs

5.3K chars

(A)(1) Semiannually, except as provided in division (A)(2) of this section, the department of medicaid shall determine each nursing facility's per medicaid day payment rate for direct care costs by multiplying the facility's semiannual case-mix score determined under section 5165…

Ohio Rev. Code Ann. § 5165.191 Resident assessment data

1.7K chars

Each calendar quarter, each nursing facility provider shall compile complete assessment data for each resident of each of the provider's nursing facilities, regardless of payment source, who is in the nursing facility, or on hospital or therapeutic leave from the nursing facility…

Ohio Rev. Code Ann. § 5165.192 Case-mix scores for nursing facilities

6.0K chars

(A)(1) Except as provided in division (B) of this section and in accordance with the process specified in rules authorized by this section, the department of medicaid shall do all of the following: (a) Every quarter, determine the following two case-mix scores for each nursing fa…

Ohio Rev. Code Ann. § 5165.193 Exception review of assessment data

3.3K chars

(A) The department of medicaid may, pursuant to rules authorized by this section, conduct an exception review of resident assessment data submitted by a nursing facility provider under section 5165.191 of the Revised Code. The department may conduct an exception review based on t…

Ohio Rev. Code Ann. § 5165.21 Per medicaid day payment rate for tax costs

0.6K chars

The department of medicaid shall determine each nursing facility's per medicaid day payment rate for tax costs. The rate for tax costs determined under this division for a nursing facility shall be used for subsequent years until the department conducts a rebasing. To determine a…

Ohio Rev. Code Ann. § 5165.23 Critical access incentive payments to qualified facilities

3.6K chars

(A) Each state fiscal year, the department of medicaid shall determine the critical access incentive payment for each nursing facility that qualifies as a critical access nursing facility. To qualify as a critical access nursing facility for a state fiscal year, a nursing facilit…

Ohio Rev. Code Ann. § 5165.26 Nursing facility's per medicaid day quality incentive payment rate

11.2K chars

(A) As used in this section: (1) "Base rate" means the portion of a nursing facility's total per medicaid day payment rate determined under divisions (A) and (B) of section 5165.15 of the Revised Code. (2) "CMS" means the United States centers for medicare and medicaid services. …

Ohio Rev. Code Ann. § 5165.28 Rate for added, replaced, or renovated beds

0.3K chars

If a provider of a nursing facility adds or replaces one or more medicaid certified beds to or at the nursing facility, or renovates one or more of the nursing facility's beds, the medicaid payment rate for the added, replaced, or renovated beds shall be the same as the medicaid …

Ohio Rev. Code Ann. § 5165.29 Cost of operating rights for relocated beds not allowable cost

0.5K chars

If one or more medicaid-certified beds are relocated from one nursing facility to another nursing facility owned by a different person or government entity and the application for the certificate of need authorizing the relocation is filed with the director of health on or after …

Ohio Rev. Code Ann. § 5165.30 Related party costs to pass through

0.3K chars

Except as provided in section 5165.17 of the Revised Code, the costs of goods, services, and facilities, furnished to a nursing facility provider by a related party are includable in the allowable costs of the provider at the reasonable cost to the related party.

Ohio Rev. Code Ann. § 5165.32 Reduction in rate not permitted

0.2K chars

The department of medicaid shall not reduce a nursing facility's medicaid payment rate determined under this chapter on the basis that the provider charges a lower rate to any resident who is not eligible for medicaid.

Ohio Rev. Code Ann. § 5165.33 No payment for discharge date

0.1K chars

No medicaid payment shall be made to a nursing facility provider for the day a medicaid recipient is discharged from the nursing facility.

Ohio Rev. Code Ann. § 5165.34 Payments made to reserve bed during temporary absence

2.1K chars

(A) The department of medicaid may make medicaid payments to a nursing facility provider under this chapter to reserve a bed for a recipient during a temporary absence under conditions prescribed by the department, to include hospitalization for an acute condition, visits with re…

Ohio Rev. Code Ann. § 5165.35 Payments made to facility for services provided after involuntary termination

0.4K chars

Medicaid payments may be made for nursing facility services provided not later than thirty days after the effective date of an involuntary termination of the nursing facility that provides the services if the services are provided to a medicaid recipient who is eligible for the s…

Ohio Rev. Code Ann. § 5165.36 Rebasing

0.3K chars

Beginning with state fiscal year 2024, the department of medicaid shall conduct a rebasing at least once every five state fiscal years. When the department conducts the rebasing for a state fiscal year, it shall conduct the rebasing for only the direct care and tax cost centers. …

Ohio Rev. Code Ann. § 5165.37 Calculating rates and making payments

1.7K chars

The department of medicaid shall make its best efforts each year to calculate nursing facilities' medicaid payment rates under this chapter in time to pay the rates by the fifteenth day of August of each state fiscal year. If the department is unable to calculate the rates so tha…

Ohio Rev. Code Ann. § 5165.38 Reconsideration of rate

1.5K chars

The medicaid director shall adopt rules under section 5165.02 of the Revised Code that establish a process under which a nursing facility provider, or a group or association of nursing facility providers, may seek reconsideration of medicaid payment rates established under this c…

Ohio Rev. Code Ann. § 5165.40 Adjustment of rates

1.3K chars

If a nursing facility provider properly amends a cost report for the nursing facility under section 5165.107 of the Revised Code and the amended report shows that the provider received a lower medicaid payment rate under the original cost report than the provider was entitled to …

Ohio Rev. Code Ann. § 5165.41 Redetermination of rates

2.0K chars

(A) The department of medicaid shall redetermine a provider's medicaid payment rate for a nursing facility using revised information if any of the following results in a determination that the provider received a higher medicaid payment rate for the nursing facility than the prov…

Ohio Rev. Code Ann. § 5165.42 Additional penalties

1.1K chars

In addition to the other penalties authorized by this chapter, the department of medicaid may impose the following penalties on a nursing facility provider:(A) If the provider does not furnish invoices or other documentation that the department requests during an audit within six…

Ohio Rev. Code Ann. § 5165.43 Determination of interest rate

0.6K chars

For the purposes of sections 5165.41 and 5165.42 of the Revised Code, the department of medicaid shall determine the current average bank prime rate using statistical release H.15, "selected interest rates," a weekly publication of the federal reserve board, or any successor publ…

Ohio Rev. Code Ann. § 5165.44 Deductions

0.7K chars

(A) Except as provided in division (B) of this section, the department of medicaid shall deduct the following from the next available medicaid payment the department makes to a nursing facility provider who continues to participate in medicaid: (1) Any amount the provider is requ…

Ohio Rev. Code Ann. § 5165.45 Deposits to general revenue fund

0.3K chars

The department of medicaid shall transmit to the treasurer of state for deposit in the general revenue fund amounts collected from the following: (A) Refunds required by, and interest charged under, section 5165.41 of the Revised Code;(B) Amounts collected from penalties imposed …

Ohio Rev. Code Ann. § 5165.46 Administrative adjudication

0.8K chars

All of the following are subject to an adjudication conducted in accordance with Chapter 119. of the Revised Code: (A) Any audit disallowance that the department of medicaid makes as the result of an audit under section 5165.109 of the Revised Code;(B) Any adverse finding that re…

Ohio Rev. Code Ann. § 5165.47 Claim for medicaid payment for service provided to nursing facility resident

0.7K chars

No person, other than a nursing facility provider, shall submit a claim for medicaid payment for a service provided to a nursing facility resident if the service is included in a medicaid payment made to the nursing facility provider under this chapter or in the allowable expense…

Ohio Rev. Code Ann. § 5165.48 Nursing facility not required to submit Medicaid claim for Medicare cost-sharing expenses under certain circumstances

0.6K chars

The provider of a nursing facility is not required to submit a claim to the department of medicaid regarding the medicare cost-sharing expenses of a resident of the nursing facility who, under federal law, is eligible to have the medicaid program pay for a part of the cost-sharin…

Ohio Rev. Code Ann. § 5165.49 Post-payment reviews of nursing facility Medicaid claims

0.8K chars

The department of medicaid may conduct a post-payment review of a claim submitted by a nursing facility provider and paid by the medicaid program to determine whether the provider was overpaid. The department shall provide the provider a written summary of the review's results. T…

Ohio Rev. Code Ann. § 5165.50 Notice of facility closure or withdrawal of participation

1.0K chars

An exiting operator or owner of a nursing facility participating in the medicaid program shall provide the department of medicaid written notice of a facility closure or voluntary withdrawal of participation not less than ninety days before the effective date of the facility clos…

Ohio Rev. Code Ann. § 5165.501 Compliance with Social Security Act required

0.2K chars

An operator shall comply with the "Social Security Act," section 1919(c)(2)(F), 42 U.S.C. 1396r(c)(2)(F) if the operator's nursing facility undergoes a voluntary withdrawal of participation.

Ohio Rev. Code Ann. § 5165.51 Notice of change of operator

4.4K chars

(A) An exiting operator or owner and entering operator shall provide the department of medicaid written notice of a change of operator if the nursing facility participates in the medicaid program and the entering operator seeks to continue the nursing facility's participation. Th…

Ohio Rev. Code Ann. § 5165.511 Agreements with entering operators effective on date of change of operator

1.3K chars

The department of medicaid may enter into a provider agreement with an entering operator that goes into effect at 12:01 a.m. on the effective date of the change of operator if all of the following requirements are met: (A) The department receives a properly completed written noti…

Ohio Rev. Code Ann. § 5165.512 Agreements with entering operators effective on a later date

2.4K chars

(A) The department of medicaid may enter into a provider agreement with an entering operator that goes into effect at 12:01 a.m. on the date determined under division (B) of this section if all of the following are the case: (1) The department receives a properly completed writte…

Ohio Rev. Code Ann. § 5165.513 Entering operator duties under provider agreement

1.4K chars

(A) A provider that enters into a provider agreement with the department of medicaid under section 5165.511 or 5165.512 of the Revised Code shall do all of the following:(1) Comply with all applicable federal statutes and regulations;(2) Comply with section 5165.07 of the Revised…

Ohio Rev. Code Ann. § 5165.514 Exiting operator deemed operator pending change

0.4K chars

In the case of a change of operator, the exiting operator shall be considered to be the operator of the nursing facility for purposes of the medicaid program, including medicaid payments, until the effective date of the entering operator's provider agreement if the provider agree…

Ohio Rev. Code Ann. § 5165.515 Provider agreement with operator not complying with prior agreement

0.8K chars

The department of medicaid may enter into a provider agreement as provided in section 5165.07 of the Revised Code, rather than section 5165.511 or 5165.512 of the Revised Code, with an entering operator if the entering operator does not agree to a provider agreement that satisfie…

Ohio Rev. Code Ann. § 5165.516 Medicaid reimbursement adjustments; change of operator

0.5K chars

The medicaid director may adopt rules under section 5165.02 of the Revised Code governing adjustments to the medicaid payment rate for a nursing facility that undergoes a change of operator. No rate adjustment resulting from a change of operator shall be effective before the effe…

Ohio Rev. Code Ann. § 5165.517 Determination of change of operator for purposes of licensure not controlling

0.4K chars

The department of health's determination that a change of operator has or has not occurred for purposes of licensure under Chapter 3721. of the Revised Code shall not affect the department of medicaid's determination of whether or when a change of operator occurs or the effective…

Ohio Rev. Code Ann. § 5165.518 Nursing facility operator identity

1.1K chars

(A) Each nursing facility shall ensure that the identity of the operator that holds the license to operate the facility issued under section 3721.02 of the Revised Code and the operator that holds the medicaid provider agreement for the facility issued under section 5165.07 of th…

Ohio Rev. Code Ann. § 5165.52 Overpayment amounts determined following notice of closure, etc

2.0K chars

(A) On receipt of a written notice under section 5165.50 of the Revised Code of a facility closure or voluntary withdrawal of participation, on receipt of a written notice under section 5165.51 of the Revised Code of a change of operator, or on the effective date of an involuntar…

Ohio Rev. Code Ann. § 5165.521 Withholding amounts owed from medicaid payments to exiting operator

9.2K chars

(A) Except as provided in divisions (B), (C), and (D) of this section, the department of medicaid may withhold from payment due an exiting operator under the medicaid program the total amount specified in the notice provided under division (C) of section 5165.52 of the Revised Co…

Ohio Rev. Code Ann. § 5165.522 Cost report by exiting operator; waiver

1.2K chars

(A) Except as provided in division (B) of this section, an exiting operator shall file with the department of medicaid a cost report not later than ninety days after the last day the exiting operator's provider agreement is in effect or, in the case of a voluntary withdrawal of p…

Ohio Rev. Code Ann. § 5165.523 Failure to file cost report; payments deemed overpayments

0.5K chars

If an exiting operator required by section 5165.522 of the Revised Code to file a cost report with the department of medicaid fails to file the cost report in accordance with that section, all payments under the medicaid program for the period the cost report is required to cover…

Ohio Rev. Code Ann. § 5165.524 Final payment withheld pending receipt of cost reports

0.3K chars

The department of medicaid may not provide an exiting operator final payment under the medicaid program until the department receives all properly completed cost reports the exiting operator is required to file under sections 5165.10 and 5165.522 of the Revised Code.

Ohio Rev. Code Ann. § 5165.525 Determination of debt of exiting operator; summary report

3.8K chars

The department of medicaid shall determine the actual amount of debt an exiting operator owes the department under the medicaid program by completing all final fiscal audits not already completed and performing all other appropriate actions the department determines to be necessa…

Ohio Rev. Code Ann. § 5165.526 Release of amount withheld less amounts owed

2.8K chars

The department of medicaid shall release the actual amount withheld under division (A) of section 5165.521 of the Revised Code, less any amount the exiting operator owes the department under the medicaid program, as follows: (A) Unless the department issues the initial debt summa…