reglab/housing_qa huggingface dataset:
Ohio Rev Code § 5124.107 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.107 | Amendments to Reports.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|(A) Except as provided in division (B) of this section and not later than three years after an ICF/IID provider files a cost report with the department of developmental disabilities under section 5124.10 or 5124.101 of the Revised Code, the provider may amend the cost report if the provider discovers a material error in the cost report or additional information to be included in the cost report. The department shall review the amended cost report for accuracy and notify the provider of its determination. (B) An ICF/IID provider may not amend a cost report if the department has notified the provider that an audit of the cost report or a cost report of the provider for a subsequent cost reporting period is to be conducted under section 5124.109 of the Revised Code. The provider may, however, provide the department information that affects the costs included in the cost report. Such information may not be provided after the adjudication of the final settlement of the cost report.
Ohio Rev Code § 5124.108 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.108 | Desk Review.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The department of developmental disabilities shall conduct a desk review of all cost reports it receives under sections 5124.10, 5124.101, and 5124.522 of the Revised Code. Based on the desk review, the department shall make a preliminary determination of whether the reported costs are allowable costs. The department shall notify each ICF/IID provider of whether any of the reported costs are preliminarily determined not to be allowable costs, the medicaid payment rate determined under this chapter as a result of the determination regarding allowable costs, and the reasons for the determination and resulting rate. The department shall allow the provider to verify the calculation and submit additional information.
Ohio Rev Code § 5124.15 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.15 | Amount of Payments.

Effective: September 30, 2021|Latest Legislation:  House Bill 110 - 134th General Assembly|(A) Except as otherwise provided by section 5124.101 of the Revised Code, sections 5124.151 to 5124.154 of the Revised Code, and divisions (B) and (C) of this section, the total per medicaid day payment rate that the department of developmental disabilities shall pay to an ICF/IID provider for ICF/IID services the provider's ICF/IID provides during a fiscal year shall equal the sum of all of the following: (1) The per medicaid day capital component rate determined for the ICF/IID under section 5124.17 of the Revised Code; (2) The per medicaid day direct care costs component rate determined for the ICF/IID under section 5124.19 of the Revised Code; (3) The per medicaid day indirect care costs component rate determined for the ICF/IID under section 5124.21 of the Revised Code; (4) The per medicaid day other protected costs component rate determined for the ICF/IID under section 5124.23 of the Revised Code; (5) The sum of the following: (a) The per medicaid day quality incentive payment determined for the ICF/IID under section 5124.24 of the Revised Code; (b) A direct support personnel payment equal to two and four-hundredths per cent of the ICF/IID's desk-reviewed, actual, allowable, per medicaid day direct care costs from the applicable cost report year. (B) The total per medicaid day payment rate for an ICF/IID that is in peer group 5 shall not exceed the average total per medicaid day payment rate in effect on July 1, 2013, for developmental centers. (C) The department shall adjust the total per medicaid day payment rate otherwise determined for an ICF/IID under this section as directed by the general assembly through the enactment of law governing medicaid payments to ICF/IID providers. (D)(1) In addition to paying an ICF/IID provider the total per medicaid day payment rate determined for the provider's ICF/IID under divisions (A), (B), and (C) of this section for a fiscal year, the department may do either or both of the following: (a) In accordance with section 5124.25 of the Revised Code, pay the provider a rate add-on for ventilator-dependent outlier ICF/IID services if the rate add-on is to be paid under that section and the department approves the provider's application for the rate add-on; (b) In accordance with section 5124.26 of the Revised Code, pay the provider for outlier ICF/IID services the ICF/IID provides to residents identified as needing intensive behavioral health support services if the rate add-on is to be paid under that section and the department approves the provider's application for the rate add-on. (2) The rate add-ons are not to be part of the ICF/IID's total per medicaid day payment rate. Last updated August 24, 2021 at 2:51 PM
Ohio Rev Code § 5124.153 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.153 | Payment Rate for Services Provided to Resident Who Meets Criteria for Admission to Outlier Icf/iid or Unit.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|(A) To the extent, if any, provided for in rules authorized by this section, the total per medicaid day payment rate determined under section 5124.15 of the Revised Code shall not be paid for ICF/IID services that an ICF/IID not designated as an outlier ICF/IID or unit provides to a resident who meets the criteria for admission to a designated outlier ICF/IID or unit, as specified in rules authorized by section 5124.152 of the Revised Code. Instead, the provider of an ICF/IID providing ICF/IID services to such a resident shall be paid each fiscal year a total per medicaid day payment rate that the department shall prospectively determine in accordance with a methodology established in rules authorized by this section. (B) The director of developmental disabilities may adopt rules under section 5124.03 of the Revised Code to implement this section. The rules may require that an ICF/IID receive authorization from the department before admitting or retaining a resident who meets the criteria for admission to a designated outlier ICF/IID or unit. If the director adopts such rules, the rules shall specify the criteria and procedures the department will apply when granting the authorization.
Ohio Rev Code § 5124.154 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.154 | Computing Rate for Services Provided by Developmental Centers.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The department of developmental disabilities is not required to pay the total per medicaid day payment rates determined under section 5124.15 of the Revised Code for ICF/IID services provided by developmental centers. Instead, the department may determine the medicaid payment rates for developmental centers according to the reasonable cost principles of Title XVIII.
Ohio Rev Code § 5124.191 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.191 | Definition of Icf/iid Resident; Assessment of Residents.

Effective: September 30, 2021|Latest Legislation:  House Bill 110 - 134th General Assembly|(A) As used in sections 5124.191 to 5124.193 of the Revised Code, "ICF/IID resident" includes an individual who is on hospital or therapeutic leave from an ICF/IID. (B) In accordance with rules adopted under section 5124.03 of the Revised Code, the department of developmental disabilities shall assess each ICF/IID resident regardless of payment source and compile complete assessment data on the residents. The department shall perform the initial assessment of an ICF/IID resident. The department may perform a subsequent assessment of an ICF/IID resident under any of the following circumstances: (1) The provider of the ICF/IID in which the resident resides or from which the resident is on hospital or therapeutic leave has submitted to the department under division (D) of this section revised assessment data for the resident or an attestation of no changes in the resident's assessment data and the department has reason to believe that the revised assessment data or attestation is inaccurate; (2) The department has reason to believe that the resident's most recent assessment no longer accurately reflects the resident's condition; (3) The department determines that the resident's most recent assessment should be updated because of the passage of time since that assessment was performed. (C) If an ICF/IID provider disagrees with the results of an assessment performed by the department under this section, the provider may request that the department reconsider the results in accordance with rules adopted under section 5124.03 of the Revised Code. (D) After the department assesses an ICF/IID resident under this section, the provider of the ICF/IID in which the resident resides or from which the resident is on hospital or therapeutic leave shall submit to the department, not later than fifteen days after the end of each subsequent calendar quarter and through the medium or media specified in rules adopted under section 5124.03 of the Revised Code, either of the following: (1) Revised assessment data for the resident if there are changes in the resident's assessment data; (2) An attestation that there are no changes in the resident's assessment data. (E) A resident assessment instrument specified in rules adopted under section 5124.03 of the Revised Code shall be used to compile or revise assessment data of ICF/IID residents under this section. Last updated August 24, 2021 at 2:54 PM
Ohio Rev Code § 5124.193 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.193 | Quarterly Determination of Case-Mix Scores.

Effective: July 1, 2018|Latest Legislation:  House Bill 24 - 132nd General Assembly|(A) Except as provided in division (B) of this section, the department of developmental disabilities shall do both of the following: (1) For each calendar quarter, determine a case-mix score for each ICF/IID using both of the following: (a) The most recent (as of the date the determination is made) resident assessment data compiled and revised for the ICF/IID's residents under section 5124.191 of the Revised Code; (b) The case-mix scores of the ICF/IID's residents as determined under section 5124.192 of the Revised Code. (2) After the end of each calendar year, determine an annual average case-mix score for each ICF/IID using the ICF/IID's quarterly case-mix scores for that calendar year. (B)(1) Subject to divisions (B)(2) and (3) of this section, the department, for one or more months of a calendar quarter, may assign to an ICF/IID a case-mix score that is five per cent less than the ICF/IID's case-mix score as of the day immediately preceding the day on which the reduction takes effect if the provider does not timely comply with division (D) of section 5124.191 of the Revised Code.  (2) Subject to division (B)(3) of this section, before assigning a case-mix score to an ICF/IID under division (B)(1) of this section, the department shall permit the provider to come into compliance with division (D) of section 5124.191 of the Revised Code. The department may assign the case-mix score if the provider fails to comply not later than forty-five days after the end of the calendar quarter to which the noncompliance pertains or a later date specified in rules authorized by this section. (3) The department shall take action under division (B)(1) or (2) of this section only in accordance with rules authorized by this section. The department shall not take an action that affects medicaid payment rates for prior payment periods except in accordance with sections 5124.41 and 5124.42 of the Revised Code. (C) The director of developmental disabilities shall adopt rules under section 5124.03 of the Revised Code as necessary to implement this section.
Ohio Rev Code § 5124.194 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.194 | Changes to Instructions, Guidelines, or Methodology.

Effective: July 1, 2018|Latest Legislation:  House Bill 24 - 132nd General Assembly|(A) No change that the department of developmental disabilities makes to either of the following is valid unless the change is applied prospectively and the department complies with division (B) of this section: (1) The department's instructions or guidelines for the resident assessment instrument used to compile or revise assessment data of ICF/IID residents under section 5124.191 of the Revised Code; (2) The methodology prescribed in rules authorized by division (C)(1)(b) of section 5124.192 of the Revised Code for calculating assessment scores for the medical, behavioral, and adaptive skills domains on the resident assessment instrument. (B) Before making a change described in division (A) of this section, the department shall do all of the following: (1) Notify all ICF/IID providers of the proposed change; (2) Provide representatives of ICF/IID providers an opportunity to provide the department their concerns about, and suggestions to revise, the proposed change; (3) In the case of a proposed change described in division (A)(2) of this section, determine that the proposed change is consistent with the documentation of ICF/IID staff time that was used to validate the methodology.
Ohio Rev Code § 5124.23 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.23 | Per Medicaid Day Other Protected Costs Component Rate.

Effective: September 30, 2021|Latest Legislation:  House Bill 110 - 134th General Assembly|For each fiscal year, the department of developmental disabilities shall determine each ICF/IID's per medicaid day other protected costs component rate. An ICF/IID's rate shall be the ICF/IID's desk-reviewed, actual, allowable, per diem other protected costs from the applicable cost report year, adjusted for inflation using the following: (A) Subject to division (B) of this section, the consumer price index for all urban consumers for nonprescription drugs and medical supplies, as published by the United States bureau of labor statistics; (B) If the United States bureau of labor statistics ceases to publish the index specified in division (A) of this section, the index that is subsequently published by the bureau and covers nonprescription drugs and medical supplies. Last updated August 24, 2021 at 2:55 PM
Ohio Rev Code § 5124.24 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.24 | Determination of per Medicaid Day Quality Incentive Payment.

Effective: October 17, 2019|Latest Legislation:  House Bill 166 - 133rd General Assembly|(A) For fiscal year 2022 and each fiscal year thereafter, the department of developmental disabilities shall determine in accordance with division (C) of this section a per medicaid day quality incentive payment for each ICF/IID that earns for the fiscal year at least one point under division (B) of this section. (B) Each fiscal year beginning with fiscal year 2022, the department, in accordance with rules authorized by this section, shall award to an ICF/IID points for quality indicators the ICF/IID meets for the fiscal year. The quality indicators used under this division shall be based on the recommendations contained in the report submitted to the director of developmental disabilities by the ICF/IID quality indicators workgroup established by Section 261.230 this act . (C) An ICF/IID's per medicaid day quality incentive payment for a fiscal year shall be the product of the following: (1) The relative weight point value for the fiscal year as determined under division (D) of this section; (2) The number of points the ICF/IID was awarded under division (B) of this section for the fiscal year. (D) The relative weight point value for a fiscal year shall be determined as follows: (1) For each ICF/IID, determine the product of the following: (a) The number of inpatient days the ICF/IID had for the applicable cost report year; (b) The number of points the ICF/IID was awarded under division (B) of this section for the fiscal year. (2) Determine the sum of all of the products determined under division (D)(1) of this section for the fiscal year; (3) Determine the amount equal to one per cent of the total desk-reviewed, actual, allowable direct care costs of all ICFs/IID for the applicable cost report year; (4) Divide the amount determined under division (D)(3) of this section by the sum determined under division (D)(2) of this section. (E) The director of developmental disabilities shall adopt rules under section 5124.03 of the Revised Code as necessary to implement this section, including rules that specify or establish all of the following: (1) The data needed for the department to determine whether an ICF/IID meets the quality indicators specified in division (B) of this section, the medium through which a report of the data is to be submitted to the department, and the date by which the report of the data must be submitted to the department; (2) Satisfactory evidence needed to determine that an ICF/IID has met the quality indicators; (3) The method by which ICFs/IID are to be awarded points under division (B) of this section and the number of points that each quality indicator is worth based on the quality indicator's relative importance compared to the other quality indicators.
Ohio Rev Code § 5124.25 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.25 | Payment of Medicaid Rate Add-on for Outlier Services Provided for Ventilator-Dependent Residents.

Effective: September 29, 2017|Latest Legislation:  House Bill 49 - 132nd General Assembly|(A) Subject to division (D) of this section, the department of developmental disabilities may pay a medicaid rate add-on to an ICF/IID provider for outlier ICF/IID services the ICF/IID provides to qualifying ventilator-dependent residents on or after September 29, 2013, if the provider applies to the department of developmental disabilities to receive the rate add-on and the department approves the application. The department of developmental disabilities may approve a provider's application if both of the following apply:(1) The provider submits to the department of developmental disabilities a best practices protocol for providing outlier ICF/IID services under this section and the department of developmental disabilities determines that the protocol is acceptable;(2) The provider and ICF/IID meet all other eligibility requirements for the rate add-on established in rules authorized by this section.(B) An ICF/IID that has been approved by the department of developmental disabilities to provider outlier ICF/IID services under this section shall provide the services in accordance with both of the following:(1) The best practices protocol the department of developmental disabilities determined is acceptable;(2) Requirements regarding the services established in rules authorized by this section.(C) To qualify to receive outlier ICF/IID services from an ICF/IID under this section, a resident of the ICF/IID must be a medicaid recipient, be dependent on a ventilator, and meet all other eligibility requirements established in rules authorized by this section.(D) The department of developmental disabilities shall negotiate the amount of the medicaid payment rate add-on, if any, to be paid under this section, or the method by which that amount is to be determined, with the department of medicaid. The department of developmental disabilities shall not pay the rate add-on unless the department of medicaid has approved the amount of the rate add-on or method by which the amount is to be determined.
Ohio Rev Code § 5124.26 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services|Section 5124.26 | Payment of Medicaid Rate Add-on for Outlier Icf/iid Services.

Effective: October 17, 2019|Latest Legislation:  House Bill 166 - 133rd General Assembly|(A) Subject to division (D) of this section, the department of developmental disabilities may pay a medicaid rate add-on to an ICF/IID provider for outlier ICF/IID services the ICF/IID provides to residents identified as needing intensive behavioral support services, if the provider applies to the department to receive the rate add-on and the department approves the application. The department may approve a provider's application if both of the following apply: (1) The provider submits to the department a best practices protocol for providing outlier ICF/IID services under this section and the department determines that the protocol is acceptable; (2) The provider meets all other eligibility requirements for the rate add-on established in rules adopted under section 5124.03 of the Revised Code. (B) An ICF/IID that has been approved by the department to provide outlier ICF/IID services under this section shall provide the services in accordance with both of the following: (1) The best practices protocol described in division (A)(1) of this section; (2) Requirements regarding the services established in rules adopted under section 5124.03 of the Revised Code. (C) To qualify to receive outlier ICF/IID services from an ICF/IID under this section, a resident of the ICF/IID must be a medicaid recipient, be determined to need intensive behavioral support services, and meet all other eligibility requirements established in rules adopted under section 5124.03 of the Revised Code. (D) The department shall negotiate with the department of medicaid the amount of the medicaid payment rate add-on, if any, to be paid under this section or the method by which that amount is to be determined.