reglab/housing_qa huggingface dataset:
Ohio Rev Code § 5164.741 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.741 | Payment for Graduate Medical Education Costs to Noncontracting Hospitals.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|(A) Except as provided in division (B) of this section, the department of medicaid may deny medicaid payment to a hospital for direct graduate medical education costs associated with the delivery of medicaid services to any medicaid recipient if the hospital refuses without good cause to contract with a medicaid managed care organization that serves the area in which the hospital is located. (B) A hospital is not subject to division (A) of this section if all of the following are the case:(1) The hospital is located in a county in which participants in the care management system are required before January 1, 2006, to be enrolled in a medicaid managed care organization that is a health insuring corporation.(2) The hospital has entered into a contract before January 1, 2006, with at least one health insuring corporation serving the participants specified in division (B)(1) of this section.(3) The hospital remains under contract with at least one health insuring corporation serving participants in the care management system who are required to be enrolled in a health insuring corporation.(C) The medicaid director shall specify in the rules adopted under section 5164.02 of the Revised Code what constitutes good cause for a hospital to refuse to contract with a medicaid managed care organization.
Ohio Rev Code § 5164.75 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.75 | Medicaid Payment for a Drug Subject to a Federal Upper Reimbursement Limit.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|As used in this section, "federal upper reimbursement limit" means the limit established pursuant to the "Social Security Act," section 1927(e), 42 U.S.C. 1396r-8(e). The medicaid payment for a drug that is subject to a federal upper reimbursement limit shall not exceed, in the aggregate, the federal upper reimbursement limit for the drug.
Ohio Rev Code § 5164.751 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.751 | State Maximum Allowable Cost Program.

Effective: April 12, 2021|Latest Legislation:  Senate Bill 263 - 133rd General Assembly|(A) As used in this section, "state maximum allowable cost" means the per unit amount the medicaid program pays a terminal distributor of dangerous drugs for a prescribed drug included in the state maximum allowable cost program established under division (B) of this section. "State maximum allowable cost" excludes dispensing fees and copayments, coinsurance, or other cost-sharing charges, if any. (B) Subject to section 5167.123 of the Revised Code, the medicaid director shall establish a state maximum allowable cost program for purposes of managing medicaid payments to terminal distributors of dangerous drugs for prescribed drugs identified by the director pursuant to this division. The director shall do all of the following with respect to the program: (1) Identify and create a list of prescribed drugs to be included in the program. (2) Update the list of prescribed drugs described in division (B)(1) of this section on a weekly basis. (3) Review the state maximum allowable cost for each prescribed drug included on the list described in division (B)(1) of this section on a weekly basis.
Ohio Rev Code § 5164.752 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.752 | Determining Maximum Dispensing Fee.

Effective: September 29, 2017|Latest Legislation:  House Bill 49 - 132nd General Assembly|In July of every even-numbered year, the department of medicaid shall initiate a confidential survey of the cost of dispensing drugs incurred by terminal distributors of dangerous drugs in this state. The survey shall be used as the basis for establishing the medicaid program's dispensing fees for terminal distributors in accordance with section 5164.753 of the Revised Code. The survey shall be completed and its results published not later than the last day of November of the year in which it is conducted.Each terminal distributor that is a provider of drugs under the medicaid program shall participate in the survey. Except as necessary to publish the survey's results, a terminal distributor's responses to the survey are confidential and not a public record under section 149.43 of the Revised Code.The survey shall be conducted in conformance with the requirements set forth in 42 C.F.R. 447.500 to 447.518. The survey shall include operational data and direct prescription expenses, professional services and personnel costs, and usual and customary overhead expenses of the terminal distributors surveyed. The survey shall compute and report the cost of dispensing by terminal distributors.
Ohio Rev Code § 5164.753 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.753 | Dispensing Fee.

Effective: September 29, 2017|Latest Legislation:  House Bill 49 - 132nd General Assembly|In December of every even-numbered year, the medicaid director shall establish dispensing fees, effective the following July, for terminal distributors of dangerous drugs that are providers of drugs under the medicaid program. In establishing dispensing fees, the director shall take into consideration the results of the survey conducted under section 5164.752 of the Revised Code. The director may establish dispensing fees that vary by terminal distributor, taking into consideration the volume of drugs a terminal distributor dispenses under the medicaid program or any other criteria the director considers relevant.
Ohio Rev Code § 5164.754 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.754 | Agreement for Multiple-State Drug Purchasing Program.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|(A) As used in this section, "dangerous drug" and "manufacturer of dangerous drugs" have the same meaning as in section 4729.01 of the Revised Code. (B) The medicaid director may enter into or administer an agreement or cooperative arrangement with other states to create or join a multiple-state prescription drug purchasing program for the purpose of negotiating with manufacturers of dangerous drugs to receive discounts or rebates for dangerous drugs covered by the medicaid program.
Ohio Rev Code § 5164.755 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.755 | Supplemental Drug Rebate Program.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The medicaid director, in rules adopted under section 5164.02 of the Revised Code, may establish and implement a supplemental drug rebate program under which drug manufacturers may be required to provide the department of medicaid a supplemental rebate as a condition of having the drug manufacturers' drug products covered by the medicaid program without prior approval. The department may receive a supplemental rebate negotiated under the program for a drug dispensed to a medicaid recipient pursuant to a prescription or a drug purchased by a medicaid provider for administration to a medicaid recipient in the provider's primary place of business. If the director establishes a supplemental drug rebate program, the director shall consult with drug manufacturers regarding the establishment and implementation of the program.
Ohio Rev Code § 5164.756 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.756 | Drug Rebate Agreement or Supplemental Drug Rebate Agreement for Medicaid Program Not Subject to Public Records Law.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|Any record, data, pricing information, or other information regarding a drug rebate agreement or a supplemental drug rebate agreement for the medicaid program that the department of medicaid receives from a pharmaceutical manufacturer or creates pursuant to negotiation of the agreement is not a public record under section 149.43 of the Revised Code and shall be treated by the department as confidential information.
Ohio Rev Code § 5164.757 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.757 | E-Prescribing Applications.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|(A) As used in this section, "licensed health professional authorized to prescribe drugs" has the same meaning as in section 4729.01 of the Revised Code. (B) The medicaid director may acquire or specify technologies to provide information regarding medicaid recipient eligibility, claims history, and drug coverage to medicaid providers through electronic health record and e-prescribing applications.If such technologies are acquired or specified, the e-prescribing applications shall enable a medicaid provider who is a licensed health professional authorized to prescribe drugs to use an electronic system to prescribe a drug for a medicaid recipient. The purpose of the electronic system is to eliminate the need for such medicaid providers to issue prescriptions for medicaid recipients by handwriting or telephone. The technologies acquired or specified by the director also shall provide such medicaid providers with an up-to-date, clinically relevant drug information database and a system of electronically monitoring medicaid recipients' medical history, drug regimen compliance, and fraud and abuse.
Ohio Rev Code § 5164.758 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.758 | Adoption of Rules for Implementation of Coordinated Services Program for Medicaid Users Who Abuse Prescription Drugs.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The medicaid director shall adopt rules under section 5164.02 of the Revised Code to implement a coordinated services program for medicaid recipients 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 implemented in a manner that is consistent with the "Social Security Act," section 1915(a)(2), 42 U.S.C. 1396n(a)(2), and 42 C.F.R. 431.54(e).
Ohio Rev Code § 5164.759 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.759 | Outpatient Drug Use Review Program.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|In accordance with the "Social Security Act," section 1927(g), 42 U.S.C. 1396r-8(g), the department of medicaid shall establish an outpatient drug use review program to assure that prescriptions obtained by medicaid recipients are appropriate, medically necessary, and unlikely to cause adverse medical results.
Ohio Rev Code § 5164.76 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.76 | Manner of Payment for Community Mental Health Service Providers or Facilities and Alcohol and Drug Addiction Services.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|(A) In rules adopted under section 5164.02 of the Revised Code, the medicaid director shall modify the manner or establish a new manner in which the following are paid under medicaid: (1) Community mental health service providers or facilities for providing community mental health services covered by the medicaid program pursuant to section 5164.15 of the Revised Code;(2) Providers of alcohol and drug addiction services for providing alcohol and drug addiction services covered by the medicaid program.(B) The director's authority to modify the manner, or to establish a new manner, for medicaid to pay for the services specified in division (A) of this section is not limited by any rules adopted under section 5119.22 or 5164.02 of the Revised Code that are in effect on June 26, 2003, and govern the way medicaid pays for those services. This is the case regardless of what state agency adopted the rules.
Ohio Rev Code § 5164.761 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.761 | Beta Testing of Updates to Billing Codes or Payment Rates.

Effective: September 29, 2017|Latest Legislation:  House Bill 49 - 132nd General Assembly|Before the department of medicaid or department of mental health and addiction services updates medicaid billing codes or medicaid payment rates for community behavioral health services as part of the behavioral health redesign, the departments shall conduct a beta test of the updates. Any medicaid provider of community behavioral health services may volunteer to participate in the beta test. An update may not begin to be implemented outside of the beta test until at least half of the medicaid providers participating in the beta test are able to submit under the beta test a clean claim for community behavioral health services that is properly adjudicated not later than thirty days after the date the clean claim is submitted.
Ohio Rev Code § 5164.78 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.78 | Medicaid Payment Rates for Certain Neonatal and Newborn Services.

Effective: November 22, 2017|Latest Legislation:  House Bill 49 - 132nd General Assembly|(A) The medicaid payment rates for the following neonatal and newborn services shall equal seventy-five per cent of the medicare payment rates for the services in effect on the date the services are provided to medicaid recipients eligible for the services:(1) Initial care for normal newborns;(2) Subsequent day, hospital care for normal newborns;(3) Same day, initial history and physical examination and discharge for normal newborns;(4) Initial neonatal critical care for children not more than twenty-eight days old;(5) Subsequent day, neonatal critical care for children not more than twenty-eight days old;(6) Subsequent day, pediatric critical care for children at least twenty-nine days but less than two years old;(7) Initial neonatal intensive care;(8) Subsequent day, neonatal intensive noncritical care for children weighing less than one thousand five hundred grams;(9) Subsequent day, neonatal intensive noncritical care for children weighing at least one thousand five hundred grams but not more than two thousand five hundred grams;(10) Subsequent day, neonatal noncritical care for children weighing more than two thousand five hundred grams but not more than five thousand grams.(B) The medicaid payment rates for other medicaid services selected by the medicaid director shall be less than the amount of the rates in effect on the effective date of this section so that the cost of the rates set pursuant to division (A) of this section do not increase medicaid expenditures. The director may not select any medicaid service for which the medicaid payment rate is determined in accordance with state statutes.
Ohio Rev Code § 5164.80 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.80 | Public Notice for Changes to Payment Rates for Medicaid Assistance.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|As necessary to comply with the "Social Security Act," section 1902(a)(13)(A), 42 U.S.C. 1396a(a)(13)(A), and any other federal law that requires public notice of proposed changes to payment rates for medicaid services, the medicaid director shall give public notice in the register of Ohio of any change to a method or standard used to determine the medicaid payment rate for a medicaid service.
Ohio Rev Code § 5164.82 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.82 | Payment for Provider-Preventable Condition.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The department of medicaid shall not knowingly make a medicaid payment for a provider-preventable condition for which federal financial participation is prohibited by regulations adopted under the "Patient Protection and Affordable Care Act," section 2702, 42 U.S.C. 1396b-1.
Ohio Rev Code § 5164.85 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.85 | Enrolling in Group Health Plan.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|(A) As used in this section, "cost-effective" and "group health plan" have the same meanings as in the "Social Security Act," section 1906, 42 U.S.C. 1396e, and any regulations adopted under that section. (B) The department of medicaid may implement a program pursuant to the "Social Security Act," section 1906, 42 U.S.C. 1396e, for the enrollment of medicaid-eligible individuals in group health plans when the department determines that enrollment is cost-effective.
Ohio Rev Code § 5164.86 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.86 | Qualified State Long-Term Care Insurance Partnership Program.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The medicaid director shall establish a qualified state long-term care insurance partnership program consistent with the definition of that term in the "Social Security Act," section 1917(b)(1)(C)(iii), 42 U.S.C. 1396p(b)(1)(C)(iii). An individual participating in the program who is subject to the medicaid estate recovery program instituted under section 5162.21 of the Revised Code shall be eligible for the reduced adjustment or recovery under division (D) of that section.
Ohio Rev Code § 5164.88 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.88 | Coordinated Care Through Health Homes.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The medicaid director may implement within the medicaid program a system under which medicaid recipients with chronic conditions are provided with coordinated care through health homes, as authorized by the "Social Security Act," section 1945, 42 U.S.C. 1396w-4.
Ohio Rev Code § 5164.881 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.881 | Health Home Services.

Effective: October 12, 2016|Latest Legislation:  House Bill 158 - 131st General Assembly|The medicaid director, in consultation with the director of developmental disabilities, may develop and implement within the medicaid program a system under which eligible individuals with chronic conditions, as defined in the "Social Security Act," section 1945 (h)(1), 42 U.S.C. 1396w-4(h)(1), who also have developmental disabilities may receive health home services, as defined in the "Social Security Act," section 1945 (h)(4), 42 U.S.C. 1396w-4(h)(4). Any such system shall focus on the needs of individuals and have as its goal improving services and outcomes under the medicaid program by improving integration of long-term care services and supportive services with primary and acute health care services.In developing any system under this section, the directors shall consult with representatives of county boards of developmental disabilities, the Ohio provider resource association, and the arc of Ohio. The directors may consult with any other individuals or entities that have an interest in the well being of individuals with developmental disabilities.
Ohio Rev Code § 5164.89 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.89 | Case Management of Nonemergency Transportation Services.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The department of medicaid may require county departments of job and family services to provide case management of nonemergency transportation services provided under the medicaid program. County departments shall provide the case management if required by the department in accordance with rules adopted under section 5164.02 of the Revised Code. The department shall determine, for the purposes of claiming federal financial participation, whether it will claim expenditures for nonemergency transportation services as administrative or program expenditures.
Ohio Rev Code § 5164.90 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.90 | Transition of Medicaid Recipients to Community Settings.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|(A) As used in this section, "MFP demonstration project" means a money follows the person demonstration project that the United States secretary of health and human services is authorized to award under section 6071 of the "Deficit Reduction Act of 2005" (Pub. L. No. 109-171, as amended). (B) To the extent funds are available under an MFP demonstration project awarded to the department of medicaid, the director of medicaid may operate the helping Ohioans move, expanding (HOME) choice demonstration component of the medicaid program to transition medicaid recipients who qualify for the demonstration component to community settings.
Ohio Rev Code § 5164.91 (2021)
2021 Ohio Revised Code|Title 51 | Public Welfare|Chapter 5164 | Medicaid State Plan Services|Section 5164.91 | Integrated Care Delivery System.

Effective: September 29, 2013|Latest Legislation:  House Bill 59 - 130th General Assembly|The medicaid director may implement a demonstration project called the integrated care delivery system to test and evaluate the integration of the care that dual eligible individuals receive under medicare and medicaid. No provision of Title LI of the Revised Code applies to the integrated care delivery system if that provision implements or incorporates a provision of federal law governing medicaid and that provision of federal law does not apply to the system.