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Ohio Statutes, Title 51

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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. § 5166.20 Additional Medicaid waiver components for home and community-based services
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(A) The department of medicaid may create the following:(1) One or more medicaid waiver components under which home and community-based services are provided to individuals with developmental disabilities as an alternative to placement in ICFs/IID;(2) One or more medicaid waiver …
Ohio Rev. Code Ann. § 5166.21 Transitions developmental disabilities waiver
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The department of medicaid shall enter into a contract with the department of developmental disabilities under section 5162.35 of the Revised Code with regard to one or more of the medicaid waiver components created by the department of medicaid under section 5166.20 of the Revis…
Ohio Rev. Code Ann. § 5166.22 Allocating enrollment numbers to county board of developmental disabilities
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(A) Subject to division (B) of this section, when the department of developmental disabilities allocates enrollment numbers to a county board of developmental disabilities for home and community-based services specified in division (A)(1) of section 5166.20 of the Revised Code an…
Ohio Rev. Code Ann. § 5166.23 Rules regarding payments for home and community-based services provided under medicaid component

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(A) Subject to division (D) of this section, the medicaid director shall adopt rules under section 5166.02 of the Revised Code establishing the payment amounts or the methods by which the payment amounts are to be determined for home and community-based services specified in divi…

Ohio Rev. Code Ann. § 5166.30 Coverage of home care attendant services

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(A) As used in sections 5166.30 to 5166.3010 of the Revised Code: (1) "Adult" means an individual at least eighteen years of age. (2) "Appropriate director" means the following: (a) The medicaid director in the context of both of the following: (i) The Ohio home care waiver progr…

Ohio Rev. Code Ann. § 5166.301 Home care attendant services providers

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The medicaid director shall enter into a provider agreement with an individual to authorize the individual to provide home care attendant services to consumers if the individual does both of the following: (A) Agrees to comply with the requirements of sections 5166.30 to 5166.301…

Ohio Rev. Code Ann. § 5166.3010 Authorized representative

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A consumer who is an adult may select an individual to act on the consumer's behalf for purposes regarding home care attendant services by submitting a written notice of the consumer's selection of an authorized representative to the appropriate director. The notice shall specifi…

Ohio Rev. Code Ann. § 5166.302 Continuing education requirements for home care attendants

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A home care attendant shall complete not less than twelve hours of in-service continuing education regarding home care attendant services each year and provide the appropriate director evidence satisfactory to the appropriate director that the attendant satisfied this requirement…

Ohio Rev. Code Ann. § 5166.303 Responsibilities of home care attendants

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A home care attendant shall do all of the following: (A) Maintain a clinical record for each consumer to whom the attendant provides home care attendant services in a manner that protects the consumer's privacy; (B) Participate in a face-to-face visit every ninety days with all o…

Ohio Rev. Code Ann. § 5166.304 Nursing assistance by home care attendants

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(A) A home care attendant may assist a consumer with nursing tasks or self-administration of medication only after the attendant does both of the following: (1) Subject to division (B) of this section, completes consumer-specific training in how to provide the assistance that the…

Ohio Rev. Code Ann. § 5166.305 Nursing assistance by home care attendants; consent and authorization

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A home care attendant shall comply with both of the following when assisting a consumer with nursing tasks or self-administration of medication: (A) The written consent of the consumer or consumer's authorized representative provided to the appropriate director under section 5166…

Ohio Rev. Code Ann. § 5166.306 Nursing assistance by home care attendants; written statement providing consent

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To consent to a home care attendant assisting a consumer with nursing tasks or self-administration of medication, the consumer or consumer's authorized representative shall provide the appropriate director a written statement signed by the consumer or authorized representative un…

Ohio Rev. Code Ann. § 5166.307 Nursing assistance by home care attendants; written statement of authorization

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To authorize a home care attendant to assist a consumer with nursing tasks or self-administration of medication, a health care professional shall provide the appropriate director a written statement signed by the health care professional that includes all of the following: (A) Th…

Ohio Rev. Code Ann. § 5166.308 Nursing assistance by home care attendants; unauthorized actions

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When authorizing a home care attendant to assist a consumer with nursing tasks or self-administration of medication, a health care professional may not authorize a home care attendant to do any of the following: (A) Perform a task that is outside of the health care professional's…

Ohio Rev. Code Ann. § 5166.309 Practice of nursing as registered nurse or licensed practical nurse not allowed by home care attendants

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A home care attendant who provides home care attendant services to a consumer in accordance with the authorizing health care professional's authorization does not engage in the practice of nursing as a registered nurse or in the practice of nursing as a licensed practical nurse i…

Ohio Rev. Code Ann. § 5166.32 Medicaid waiver for individuals with cystic fibrosis

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If the department of medicaid terminates the 209(b) option, the department shall establish a medicaid waiver component under which an individual who has cystic fibrosis and is enrolled in the program for children and youth with special health care needs administered by the depart…

Ohio Rev. Code Ann. § 5166.37 Medicaid waiver - additional eligibility requirements for members of expansion group

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(A) The medicaid director shall establish a medicaid waiver component under which an individual eligible for medicaid on the basis of being included in the expansion eligibility group must satisfy at least one of the following requirements to be able to enroll in medicaid as part…

Ohio Rev. Code Ann. § 5166.40 Definitions

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(A) As used in sections 5166.40 to 5166.409 of the Revised Code:(1) "Adult" means an individual who is at least eighteen years of age.(2) "Buckeye account" means a modified health savings account established under section 5166.402 of the Revised Code.(3) "Contribution" means the …

Ohio Rev. Code Ann. § 5166.401 Enrolllment for healthy Ohio program participants

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A healthy Ohio program participant shall enroll in a comprehensive health plan offered by a managed care organization under contract with the department of medicaid. All of the following apply to the health plan:(A) It shall cover physician, hospital inpatient, hospital outpatien…

Ohio Rev. Code Ann. § 5166.402 Buckeye accounts for participants

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(A)(1) A buckeye account shall be established for each healthy Ohio program participant. Subject to division (A)(2) of this section, a participant's buckeye account shall consist of both of the following:(a) The medicaid funds deposited into the account under division (B) of this…

Ohio Rev. Code Ann. § 5166.403 Debit swipe cards

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(A) A managed care organization that offers the health plan in which a healthy Ohio program participant enrolls shall issue a debit swipe card to be used to pay only for the following:(1) Until the amount of the noncore portion of the participant's buckeye account is zero, the co…

Ohio Rev. Code Ann. § 5166.404 Points award system

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(A) The medicaid director shall establish a system under which points are awarded in accordance with this section to healthy Ohio program debit swipe cards. One dollar of medicaid funds shall be deposited into a healthy Ohio program participant's buckeye account for each point aw…

Ohio Rev. Code Ann. § 5166.405 Cessation of participation

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(A) A healthy Ohio program participant's participation in the program shall cease if any of the following applies:(1) Unless the participant is pregnant, a monthly installment payment to the participant's buckeye account is sixty days late.(2) The participant fails to submit docu…

Ohio Rev. Code Ann. § 5166.406 Exhaustion of payout limits

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If a healthy Ohio program participant exhausts the annual or lifetime payout limits specified in division (D) of section 5166.401 of the Revised Code, the participant shall be transferred to the fee-for-service component of medicaid or the care management system. A participant wh…

Ohio Rev. Code Ann. § 5166.407 Disqualification for medicaid; disposition of remainder in buckeye account

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(A) If a healthy Ohio program participant ceases to qualify for medicaid due to increased family countable income and purchases a health insurance policy or obtains health care coverage under an eligible employer-sponsored health plan, the amount remaining in the former participa…

Ohio Rev. Code Ann. § 5166.408 Referral to workforce development agency

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Each county department of job and family services shall offer to refer to a local board each healthy Ohio program participant who resides in the county served by the county department and is either unemployed or employed for less than an average of twenty hours per week. The refe…

Ohio Rev. Code Ann. § 5166.409 Rules

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The medicaid director shall adopt rules under section 5166.02 of the Revised Code to do all of the following:(A) For the purpose of division (F)(1)(a) of section 5166.402 of the Revised Code, establish requirements regarding preventative health services for healthy Ohio program p…

Ohio Rev. Code Ann. § 5166.45 Medicaid enrollment for chidren through age three

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(A) As used in this section, "medical assistance program" and "refugee medical assistance program" have the same meanings as in section 5160.01 of the Revised Code. (B) The medicaid director shall establish a medicaid waiver component to provide continuous medicaid enrollment for…

Ohio Rev. Code Ann. § 5166.50 Reentry services waiver

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(A) Within one year of the effective date of this section, the department of medicaid shall apply for a medicaid waiver component to provide reentry services to medicaid-eligible imprisoned individuals for ninety days before an imprisoned individual's expected release date. The b…

Ohio Rev. Code Ann. § 5167.01 Definitions

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As used in this chapter: (A) "340B grantee" means an entity described in section 340B(a)(4)(A)-(K) of the "Public Health Service Act," 42 U.S.C. 256b(a)(4)(A)-(K) that is designated as an active (A)-(K) entity under the health resources and services administration covered entity …

Ohio Rev. Code Ann. § 5167.02 Rules

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The medicaid director shall adopt rules as necessary to implement this chapter. The rules shall be adopted in accordance with Chapter 119. of the Revised Code.

Ohio Rev. Code Ann. § 5167.03 Care management system

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(A) As part of the medicaid program, the department of medicaid shall establish a care management system. The department shall implement the system in some or all counties. (B) The department shall designate the medicaid recipients who are required or permitted to participate in …

Ohio Rev. Code Ann. § 5167.031 Recognition of pediatric accountable care organizations

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(A) As used in this section: (1) "Children's care network" means any of the following:(a) A children's hospital;(b) A group of children's hospitals;(c) A group of pediatric physicians.(2) "Children's hospital" has the same meaning as in section 2151.86 of the Revised Code.(B) If …

Ohio Rev. Code Ann. § 5167.04 Inclusion of alcohol, drug addiction, and mental health services in care management system

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The department of medicaid shall include alcohol, drug addiction, and mental health services covered by medicaid in the care management system.

Ohio Rev. Code Ann. § 5167.05 Inclusion of prescribed drugs in care management system

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The department of medicaid may include prescribed drugs covered by the medicaid program in the care management system.

Ohio Rev. Code Ann. § 5167.051 Coverage of services provided by pharmacist

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If the medicaid program covers the pharmacist services described in section 5164.14 of the Revised Code, the department of medicaid may include the services in the care management system.

Ohio Rev. Code Ann. § 5167.09 Managed care financial dashboard information

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The department of medicaid shall include all of the following on the department's managed care financial dashboard: (A) Actuarial metrics for annual and quarterly cost reports, delineated by the following categories: (1) Adults for whom financial eligibility for the medicaid prog…

Ohio Rev. Code Ann. § 5167.10 Authority to contract with managed care orgainizations

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The department of medicaid may enter into contracts with managed care organizations under which the organizations are authorized to provide, or arrange for the provision of, health care services to medicaid recipients who are required or permitted to participate in the care manag…

Ohio Rev. Code Ann. § 5167.101 Basis of hospital inpatient capital payment portion of payment to medicaid managed care organization

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(A) Subject to division (B) of this section, the department of medicaid or its actuary shall base the hospital inpatient capital payment portion of the payment made to a medicaid managed care organization on data for services provided to all of the organization's enrollees, as re…

Ohio Rev. Code Ann. § 5167.103 Performance metrics; publication

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In addition to the managed care performance payment program created under section 5167.30 of the Revised Code, the department of medicaid shall establish performance metrics that will be used to evaluate and compare how medicaid managed care organizations perform under the contra…

Ohio Rev. Code Ann. § 5167.11 Managed care organization contract to provide grievance process

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Each medicaid managed care organization shall provide a grievance process for the organization's enrollees in accordance with 42 C.F.R. 438, subpart F.

Ohio Rev. Code Ann. § 5167.12 Requirements when prescribed drugs are included in care management system

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If prescribed drugs are included in the care management system: (A) Medicaid MCO plans may include strategies for the management of drug utilization, but any such strategies are subject to the limitations and requirements of this section and the approval of the department of medi…

Ohio Rev. Code Ann. § 5167.122 Disclosure of sources of payment

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(A) The state pharmacy benefit manager shall, on request from the department of medicaid, disclose to the department all sources of payment it receives for prescribed drugs, including any financial benefits such as drug rebates, discounts, credits, clawbacks, fees, grants, charge…

Ohio Rev. Code Ann. § 5167.123 Medicaid MCO contracts with 340B program participants

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(A) No contract between a medicaid managed care organization, including a third-party administrator, and a 340B grantee shall contain any of the following provisions: (1) A payment rate for a prescribed drug provided by a 340B grantee to an individual as a result of health care s…

Ohio Rev. Code Ann. § 5167.13 Implementation of coordinated services program for enrollees who abuse prescribed drugs

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Each medicaid managed care organization shall implement a coordinated services program for the organization's enrollees who are found to have obtained prescribed drugs under the medicaid program at a frequency or in an amount that is not medically necessary. The program shall be …

Ohio Rev. Code Ann. § 5167.14 Data security agreements for managed care organization's use of drug database

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Each medicaid managed care organization shall enter into a data security agreement with the state board of pharmacy governing the managed care organization's use of the board's drug database established and maintained under section 4729.75 of the Revised Code. This section does n…

Ohio Rev. Code Ann. § 5167.15 Chiropractic services

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When contracting under section 5167.10 of the Revised Code with a medicaid managed care organization, the department of medicaid shall require the organization to comply with section 5164.061 of the Revised Code as if the organization were the department. This section does not li…

Ohio Rev. Code Ann. § 5167.16 Home visits and cognitive behavioral therapy

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(A) As used in this section: (1) "Help me grow program" means the program established by the department of health pursuant to section 5180.21 of the Revised Code. (2) "Targeted case management" has the same meaning as in 42 C.F.R. 440.169(b). (B) A medicaid managed care organizat…

Ohio Rev. Code Ann. § 5167.17 Enhanced care management services for pregnant women and women capable of becoming pregnant

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Each medicaid managed care organization shall provide enhanced care management services for pregnant women and women capable of becoming pregnant in the communities specified in rules adopted under section 3701.142 of the Revised Code. The services shall be provided in a manner i…

Ohio Rev. Code Ann. § 5167.171 Uniform prior approval form for progesterone

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Each medicaid managed care organization shall, if the organization requires practitioners to obtain prior approval before administering progesterone to the organization's enrollees who are pregnant, use a uniform prior approval form for progesterone that is not more than one page…