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2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5167 | Medicaid Managed Care › Section 5167.47 | Compliance With Federal Mental Health and Addiction Parity Laws.

Effective:
March 24, 2021
Latest Legislation:
Senate Bill 284 - 133rd General Assembly
(A) When contracting with a medicaid managed care organization, the department of medicaid shall require the medicaid managed care organization to provide to medicaid enrollees the same benefits and rights as required under division (B) of section 3902.36 of the Revised Code.
(B) The medicaid director shall do both of the following:
(1) Implement and enforce division (B) of section 3902.36 of the Revised Code with respect to medicaid managed care organizations;
(2) Enforce, monitor compliance with, and ensure continued compliance with this section.
(C) The director may adopt rules under section 5167.02 of the Revised Code as necessary to carry out the provisions of this section.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.02 | [Repealed Effective 10/16/2025] Adoption of Rules.

Effective:
October 3, 2023
Latest Legislation:
House Bill 33 - 135th General Assembly
(A) The medicaid director shall adopt rules in accordance with Chapter 119. of the Revised Code for the purpose of administering sections 5168.01 to 5168.14 of the Revised Code, including rules that do all of the following:
(1) Define as a "disproportionate share hospital" any hospital included under the "Social Security Act," section 1923(b), 42 U.S.C. 1396r-4(b), and any other hospital the director determines appropriate;
(2) Prescribe the form for submission of cost reports under section 5168.05 of the Revised Code;
(3) Establish, in accordance with division (A) of section 5168.06 of the Revised Code, the assessment rate or rates to be applied to hospitals under that section;
(4) Establish schedules for hospitals to pay installments on their assessments under section 5168.06 of the Revised Code and for governmental hospitals to pay installments on their intergovernmental transfers under section 5168.07 of the Revised Code;
(5) Establish procedures to notify hospitals of adjustments made under division (B)(2)(b) of section 5168.06 of the Revised Code in the amount of installments on their assessment;
(6) Establish procedures to notify hospitals of adjustments made under division (D) of section 5168.08 of the Revised Code in the total amount of their assessment and to adjust for the remainder of the program year the amount of the installments on the assessments;
(7) Establish, in accordance with section 5168.09 of the Revised Code, the methodology for paying hospitals under that section.
The director shall consult with hospitals when adopting the rules required by divisions (A)(4) and (5) of this section in order to minimize hospitals' cash flow difficulties.
(B) Rules adopted under this section may provide that "total facility costs" excludes costs associated with any of the following:
(1) Medicaid recipients;
(2) Recipients of the program for children and youth with special health care needs established under section 3701.023 of the Revised Code;
(3) Medicare beneficiaries;
(4) Recipients of Title V of the "Social Security Act," 42 U.S.C. 701 et seq.;
(5) Any other category of costs deemed appropriate by the director in accordance with Title XIX of the "Social Security Act," 42 U.S.C. 1396 et seq., and the rules adopted under that title.
Last updated September 26, 2023 at 12:10 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.03 | [Repealed Effective 10/16/2025] Provisions Dependent on Assessment as Permissible Health Care-Related Tax.

Effective:
October 17, 2019
Latest Legislation:
House Bill 166 - 133rd General Assembly
The requirements of sections 5168.06 to 5168.09 of the Revised Code apply only as long as the United States centers for medicare and medicaid services determines that the assessment imposed under section 5168.06 of the Revised Code is a permissible health care-related tax pursuant to the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w). Whenever the department of medicaid is informed that the assessment is an impermissible health care-related tax, the department shall promptly refund to each hospital the amount of money currently in the hospital care assurance program fund created by section 5168.11 of the Revised Code that has been paid by the hospital under section 5168.06 or 5168.07 of the Revised Code, plus any investment earnings on that amount.
Last updated September 26, 2023 at 12:11 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.04 | [Repealed Effective 10/16/2025] Program Year Basis of Operation.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
The department of medicaid shall operate the hospital care assurance program established by sections 5168.01 to 5168.14 of the Revised Code on a program year basis. The department shall complete all program requirements on or before the thirtieth day of September each year.
Last updated September 26, 2023 at 12:11 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.05 | [Repealed Effective 10/16/2025] Submitting Financial Statement and Cost Report.

Effective:
October 17, 2019
Latest Legislation:
House Bill 166 - 133rd General Assembly
(A) Except as provided in division (C) of this section, each hospital, on or before the first day of July of each year or at a later date approved by the medicaid director, shall submit to the department of medicaid a financial statement for the preceding calendar year that accurately reflects the income, expenses, assets, liabilities, and net worth of the hospital, and accompanying notes. A hospital that has a fiscal year different from the calendar year shall file its financial statement within one hundred eighty days of the end of its fiscal year or at a later date approved by the director. The financial statement shall be prepared by an independent certified public accountant and reflect an official audit report prepared in a manner consistent with generally accepted accounting principles. The financial statement shall, to the extent that the hospital has sufficient financial records, show bad debt and charity care separately from courtesy care and contractual allowances.
(B) Except as provided in division (C) of this section, each hospital, within one hundred eighty days after the end of the hospital's cost reporting period, shall submit to the department a cost report in a format prescribed in rules adopted under section 5168.02 of the Revised Code. The department shall grant a hospital an extension of the one hundred eighty day period if the United States centers for medicare and medicaid services extends the date by which the hospital must submit its cost report for the hospital's cost reporting period.
(C) The director may adopt rules under section 5168.02 of the Revised Code specifying financial information that must be submitted by hospitals for which no financial statement or cost report is available. The rules shall specify deadlines for submitting the information. Each such hospital shall submit the information specified in the rules not later than the deadline specified in the rules.
Last updated September 26, 2023 at 12:13 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.06 | [Repealed Effective 10/16/2025] Annual Assessment.

Effective:
October 17, 2019
Latest Legislation:
House Bill 166 - 133rd General Assembly
(A) For the purpose of distributing funds to hospitals under the medicaid program pursuant to sections 5168.01 to 5168.14 of the Revised Code and depositing funds into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code, there is hereby imposed an assessment on all hospitals. Each hospital's assessment shall be based on total facility costs. All hospitals shall be assessed according to the rate or rates established each program year in rules adopted under section 5168.02 of the Revised Code. The department shall assess all hospitals uniformly and in a manner consistent with federal statutes and regulations. During any program year, the department shall not assess any hospital more than two per cent of the hospital's total facility costs.
The department shall establish an assessment rate or rates each program year that will do both of the following:
(1) Yield funds that, when combined with intergovernmental transfers and federal matching funds, will produce a program of sufficient size to pay a substantial portion of the indigent care provided by hospitals;
(2) Yield funds that, when combined with intergovernmental transfers and federal matching funds, will produce amounts for distribution to disproportionate share hospitals that do not exceed, in the aggregate, the limits prescribed by the United States centers for medicare and medicaid services under the "Social Security Act," section 1923(f), 42 U.S.C. 1396r-4(f).
(B)(1) Except as provided in division (B)(3) of this section, each hospital shall pay its assessment in periodic installments in accordance with a schedule established in rules adopted under section 5168.02 of the Revised Code.
(2) The installments shall be equal in amount, unless either of the following applies:
(a) The department makes adjustments during a program year under division (D) of section 5168.08 of the Revised Code in the total amount of hospitals' assessments;
(b) The medicaid director determines that adjustments in the amounts of installments are necessary for the administration of sections 5168.01 to 5168.14 of the Revised Code and that unequal installments will not create cash flow difficulties for hospitals.
(3) The director may adopt rules under section 5168.02 of the Revised Code establishing alternate schedules for hospitals to pay assessments under this section in order to reduce hospitals' cash flow difficulties.
Last updated September 26, 2023 at 12:14 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.07 | [Repealed Effective 10/16/2025] Requiring Governmental Hospitals to Make Intergovernmental Transfers.

Effective:
October 17, 2019
Latest Legislation:
House Bill 166 - 133rd General Assembly
(A) The department of medicaid may require governmental hospitals to make intergovernmental transfers each program year for the purpose of distributing funds to hospitals under the medicaid program pursuant to sections 5168.01 to 5168.14 of the Revised Code and depositing funds into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code. The department shall not require transfers in an amount that, when combined with hospital assessments paid under section 5168.06 of the Revised Code and federal matching funds, produce amounts for distribution to disproportionate share hospitals that, in the aggregate, exceed limits prescribed by the United States centers for medicare and medicaid services under the "Social Security Act," section 1923(f), 42 U.S.C. 1396r-4(f).
(B) Before or during each program year, the department shall notify each governmental hospital of the amount of the intergovernmental transfer it is required to make during the program year. Each governmental hospital shall make intergovernmental transfers as required by the department under this section in periodic installments, executed by electronic fund transfer, in accordance with a schedule established in rules adopted under section 5168.02 of the Revised Code.
Last updated September 26, 2023 at 12:17 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.10 | [Repealed Effective 10/16/2025] Prohibiting Replacing Funds Appropriated for Medicaid Program.

Effective:
September 29, 2017
Latest Legislation:
House Bill 49 - 132nd General Assembly
Except for moneys deposited into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code, the department of medicaid shall not use money paid to the department under sections 5168.06 and 5168.07 of the Revised Code or money that the department pays to hospitals under section 5168.09 of the Revised Code to replace any funds appropriated by the general assembly for the medicaid program.
Last updated September 26, 2023 at 12:27 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.13 | [Repealed Effective 10/16/2025] Confidentiality.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
Except as specifically required by sections 5168.01 to 5168.14 of the Revised Code, information filed under those sections shall not include any patient-identifying material. Information that includes patient-identifying material is not a public record under section 149.43 of the Revised Code, and no patient-identifying material shall be released publicly by the department of medicaid or by any person under contract with the department who has access to such information.
Last updated September 26, 2023 at 12:32 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.21 | [Repealed Effective 10/1/2025] Additional Annual Assessment.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
(A) For the purposes specified in section 5168.25 of the Revised Code and subject to section 5168.28 of the Revised Code, there is hereby imposed an assessment on all hospitals each assessment program year. The amount of a hospital's assessment for an assessment program year shall equal the applicable assessment percentage of the hospital's total facility costs for the period of time specified in division (B) of this section. The amount of a hospital's total facility costs shall be derived from cost-reporting data for the hospital submitted to the department of medicaid for purposes of the hospital care assurance program. If a hospital has not submitted that cost-reporting data to the department, the amount of a hospital's total facility costs shall be derived from other financial statements that the hospital shall provide to the department as directed by the department. The cost-reporting data or financial statements used to determine a hospital's assessment is subject to the same type of adjustments made to the cost-reporting data under the hospital care assurance program.
(B) The period of time specified in this division is the hospital's cost reporting period that ends in the state fiscal year that ends in the federal fiscal year that precedes the federal fiscal year that precedes the assessment program year for which the assessment is imposed.
(C) The assessment imposed by this section on a hospital is in addition to the assessment imposed by section 5168.06 of the Revised Code.
Last updated September 26, 2023 at 12:34 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.22 | [Repealed Effective 10/1/2025] Preliminary Determination of Assessment Amount.

Effective:
October 3, 2023
Latest Legislation:
House Bill 33 - 135th General Assembly
(A) Before or during each assessment program year, the department of medicaid shall issue to each hospital the preliminary determination of the amount that the hospital is assessed under section 5168.21 of the Revised Code for the assessment program year. Except as provided in division (B) of this section, the preliminary determination becomes the final determination for the assessment program year fifteen days after the preliminary determination is issued to the hospital.
(B) A hospital may request that the department reconsider the preliminary determination issued to the hospital under division (A) of this section by submitting to the department a written request for a reconsideration not later than fourteen days after the hospital's preliminary determination is issued to the hospital. The request must be accompanied by written materials setting forth the basis for the reconsideration. On receipt of the timely request, the department shall reconsider the preliminary determination and may adjust the preliminary determination on the basis of the written materials accompanying the request. The result of the reconsideration is the final determination of the hospital's assessment under section 5168.21 of the Revised Code for the assessment program year.
(C) The department shall issue to each hospital a written notice of the final determination of its assessment for the assessment program year. A hospital may appeal the final determination to the court of common pleas of Franklin county. While a judicial appeal is pending, the hospital shall pay, in accordance with section 5168.23 of the Revised Code, any amount of its assessment that is not in dispute.
Last updated September 26, 2023 at 12:37 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.23 | [Repealed Effective 10/1/2025] Assessment Payment Schedule.

Effective:
October 3, 2023
Latest Legislation:
House Bill 33 - 135th General Assembly
Each hospital shall pay the amount it is assessed under section 5168.21 of the Revised Code in accordance with a payment schedule the department of medicaid shall establish for each assessment program year. The department shall consult with the Ohio hospital association before establishing the payment schedule for any assessment program year. The department shall include the payment schedule in each preliminary determination notice the department issues to hospitals under division (A) of section 5168.22 of the Revised Code.
Last updated September 26, 2023 at 12:49 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.24 | [Repealed Effective 10/1/2025] Audit.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
The department of medicaid may audit a hospital to ensure that the hospital properly pays the amount it is assessed under section 5168.21 of the Revised Code. The department shall take action to recover from a hospital any amount the audit reveals that the hospital should have paid but did not pay.
Last updated September 26, 2023 at 12:40 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.25 | [Repealed Effective 10/1/2025] Hospital Assessment Fund.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
There is hereby created in the state treasury the hospital assessment fund. All installment payments made by hospitals under section 5168.23 of the Revised Code and all recoveries the department of medicaid makes under section 5168.24 of the Revised Code shall be deposited into the fund. All investment earnings of the fund shall be credited to the fund. The department shall use money in the fund to pay for the costs of the medicaid program, including the program's administrative costs.
Last updated September 26, 2023 at 12:41 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.26 | [Repealed Effective 10/1/2025] Excluded Costs.

Effective:
October 3, 2023
Latest Legislation:
House Bill 33 - 135th General Assembly
(A) The medicaid director shall adopt rules in accordance with Chapter 119. of the Revised Code as necessary to implement sections 5168.20 to 5168.28 of the Revised Code, including rules that specify the percentage of hospitals' total facility costs to be used in calculating hospitals' assessments under section 5168.21 of the Revised Code.
(B) The rules adopted under this section may do the following:
(1) Provide that a hospital's total facility costs for the purpose of the assessment under section 5168.21 of the Revised Code exclude any of the following:
(a) A hospital's costs associated with providing care to recipients of any of the following:
(i) The medicaid program;
(ii) The medicare program;
(iii) The program for children and youth with special health care needs established under section 3701.023 of the Revised Code;
(iv) Services provided under the maternal and child health services block grant established under Title V of the "Social Security Act," 42 U.S.C. 701 et seq.
(b) Any other category of hospital costs the director deems appropriate under federal law and regulations governing the medicaid program.
(2) Subject to division (C) of this section, provide for the percentage of hospitals' total facility costs used in calculating hospitals' assessments to vary for different hospitals.
(C) Before adopting rules authorized by division (B)(2) of this section that establish varied percentages to be used in calculating hospitals' assessments, the director shall obtain a waiver from the United States secretary of health and human services under the "Social Security Act," section 1903(w)(3)(E), 42 U.S.C. 1396b(w)(3)(E), if the varied percentages would cause the assessments to not be imposed uniformly.
Last updated September 26, 2023 at 12:43 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.27 | [Repealed Effective 10/1/2025] Implementation Shall Not Cause Reduction in Federal Participation for Medicaid Program.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
The medicaid director shall implement the assessment imposed by section 5168.21 of the Revised Code in a manner that does not cause a reduction in federal financial participation for the medicaid program under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w).
Last updated September 26, 2023 at 12:43 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.28 | [Repealed Effective 10/1/2025] Determination of Assessment as Impermissible Health Care-Related Tax.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
If the United States secretary of health and human services determines that the assessment imposed by section 5168.21 of the Revised Code is an impermissible health care-related tax under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w), the medicaid director shall take all necessary actions to cease implementation of sections 5168.20 to 5168.27 of the Revised Code and shall promptly refund to each hospital the amount of money in the hospital assessment fund at the time the refund is to be made that the hospital paid under section 5168.23 of the Revised Code, plus any corresponding investment earnings on that amount.
Last updated September 26, 2023 at 12:44 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.41 | Determination of Nursing Home and Hospital Long-Term Care Franchise Permit Fee Rate.

Effective:
July 1, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
(A) The franchise permit fee rate shall be determined for each fiscal year as follows:
(1) Determine the estimated total net patient revenues for all nursing homes and hospital long-term care units for the fiscal year;
(2) Multiply the estimated total net patient revenues determined under division (A)(1) of this section by the lesser of the following:
(a) The indirect guarantee percentage;
(b) Six per cent.
(3) Divide the product determined under division (A)(2) of this section by the number of days in the fiscal year;
(4) Determine the sum of the following:
(a) The total number of beds in all nursing homes and hospital long-term care units that are subject to the franchise permit fee for the fiscal year;
(b) The total number of nursing home beds that are exempt from the franchise permit fee for the fiscal year because of the waiver obtained pursuant to section 5168.43 of the Revised Code.
(5) Divide the quotient determined under division (A)(3) of this section by the sum determined under division (A)(4) of this section.
(B) In determining the estimated total net patient revenues for all nursing homes and hospital long-term care units for a fiscal year, the department of medicaid shall use at least all of the following:
(1) Information from medicaid cost reports filed under section 5165.10 of the Revised Code that are the most recent at the time the determination is made;
(2) The projected total medicaid payment rates for nursing facility services for the fiscal year;
(3) The projected total number of medicaid days for the fiscal year.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.43 | Waiver of Franchise Permit Fee.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
(A) Not later than four months after July 17, 2009, the department of medicaid shall apply to the United States secretary of health and human services for a waiver under the "Social Security Act," section 1903(w)(3)(E), 42 U.S.C. 1396b(w)(3)(E), as necessary to do both of the following regarding the franchise permit fee assessed under section 5168.42 of the Revised Code:
(1) Reduce the franchise permit fee rate to zero dollars for each nursing home licensed under section 3721.02 or 3721.09 of the Revised Code to which either of the following applies:
(a) The nursing home:
(i) Is exempt from state taxation under section 140.08 of the Revised Code or is exempt from state taxation as a home for the aged as defined in section 5701.13 of the Revised Code;
(ii) Is exempt from federal income taxation under section 501 of the Internal Revenue Code of 1986;
(iii) Does not participate in medicaid or medicare; and
(iv) Provides services for the life of each resident without regard to the resident's ability to secure payment for the services.
(b) The nursing home:
(i) Has had a written affiliation agreement with a university in this state for education and research related to Alzheimer's disease for each of the twenty years preceding July 17, 2009, and has such an agreement on July 17, 2009;
(ii) Was constructed pursuant to a certificate of need granted under Section 3 of Am. Sub. S.B. 256 of the 116th general assembly; and
(iii) Does not participate in medicaid or medicare.
(2) For each nursing facility with more than two hundred beds certified as nursing facility beds under Title XIX, reduce the franchise permit fee rate for a number of the nursing facility's beds specified by the department to the amount necessary to obtain approval of the waiver sought under this section.
(B) The effective date of the waiver sought under this section shall be the first day of the quarter beginning after the United States secretary approves the waiver.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.44 | Approval of Waiver; Reduction in Franchise Permit Fee Rate.

Effective:
September 29, 2015
Latest Legislation:
House Bill 64 - 131st General Assembly
If the United States secretary of health and human services approves the waiver sought under section 5168.43 of the Revised Code, the department of medicaid shall, for each nursing home and hospital that qualifies for a reduction of its franchise permit fee rate under the waiver, reduce the franchise permit fee rate in accordance with the terms of the waiver. For purposes of the first fiscal year during which the waiver takes effect, the department shall determine the amount of the reduction not later than the effective date of the waiver and shall mail to each nursing home and hospital qualifying for the reduction notice of the reduction not later than the last day of the first month of the quarter that begins after the United States secretary approves the waiver. For purposes of subsequent fiscal years, the department shall make such determinations and notify the nursing homes and hospitals in accordance with section 5168.47 of the Revised Code.
Last updated April 11, 2022 at 3:59 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.45 | Increase in Franchise Permit Fee Rate.

Effective:
September 29, 2015
Latest Legislation:
House Bill 64 - 131st General Assembly
(A) If the United States secretary of health and human services approves the waiver sought under section 5168.43 of the Revised Code, the department of medicaid may do both of the following regarding the franchise permit fee assessed under section 5168.42 of the Revised Code:
(1) Determine how much money the franchise permit fee would have raised in a fiscal year if not for the waiver;
(2) For each nursing home and hospital subject to the franchise permit fee, other than a nursing home or hospital that has its franchise permit fee rate reduced under section 5168.44 of the Revised Code, uniformly increase the amount of the franchise permit fee rate for a fiscal year to an amount that will have the franchise permit fee raise an amount of money that does not exceed the amount determined under division (A)(1) of this section for that fiscal year.
(B) If the department increases the franchise permit fee rate in accordance with division (A) of this section for the first fiscal year during which the waiver takes effect, the department shall determine the amount of the increase not later than the effective date of the waiver and shall mail to each nursing home and hospital subject to the increase notice of the increase not later than the last day of the first month of the quarter that begins after the United States secretary approves the waiver. If the department increases the franchise permit fee rate in accordance with division (A) of this section for a subsequent fiscal year, the department shall make such determinations and notify the nursing homes and hospitals in accordance with section 5168.47 of the Revised Code.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.46 | Annual Reports.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
The department of health shall do all of the following:
(A) For the purpose of the determinations made under divisions (A) and (B) of section 5168.42 of the Revised Code and not later than the first day of each June, report to the department of medicaid the following:
(1) For each nursing home, the number of beds in the nursing home licensed on the preceding first day of May under section 3721.02 or 3721.09 of the Revised Code or certified on that date under Title XVIII or Title XIX;
(2) For each hospital, the number of beds in the hospital registered on the preceding first day of May pursuant to section 3701.07 of the Revised Code as skilled nursing facility or long-term care beds or licensed on that date under section 3721.02 or 3721.09 of the Revised Code as nursing home beds.
(B) For the purpose of the redetermination under section 5168.48 of the Revised Code and not later than the fifteenth day of each January, report to the department of medicaid, for each nursing home and hospital, the number of beds for which a bed surrender occurred during the period beginning on the first day of May of the preceding calendar year and ending on the first day of January of the calendar year in which the redetermination is made.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.47 | Determination, Notice, and Payment of Annual Fee.

Effective:
September 29, 2015
Latest Legislation:
House Bill 64 - 131st General Assembly
(A) Not later than the fifteenth day of September of each year, the department of medicaid shall determine the annual franchise permit fee for each nursing home and hospital in accordance with section 5168.42 of the Revised Code and any adjustments made in accordance with sections 5168.44 and 5168.45 of the Revised Code.
(B) Not later than the first day of October of each year, the department shall notify, electronically or by United States postal service, each nursing home and hospital of the amount of the franchise permit fee that has been determined for the nursing home or hospital.
(C) Subject to section 5168.48 of the Revised Code, each nursing home and hospital shall pay its fee under section 5168.42 of the Revised Code, as adjusted in accordance with sections 5168.44 and 5168.45 of the Revised Code, to the department in four installment payments not later than forty-five days after the last day of each October, December, March, and June.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.48 | Redetermination of Franchise Permit Fees.

Effective:
September 29, 2015
Latest Legislation:
House Bill 64 - 131st General Assembly
(A) Not later than the last day of February of each year, the department of medicaid shall redetermine each nursing home's and hospital's franchise permit fee if one or more bed surrenders occur during the period beginning on the first day of May of the preceding calendar year and ending on the first day of January of the calendar year in which the redetermination is made.
(B) In redetermining nursing homes' and hospitals' franchise permit fees under this section, the department shall do both of the following:
(1) Provide for the redetermination to be conducted in a manner consistent with the terms of the waiver sought under section 5168.43 of the Revised Code;
(2) Recalculate each nursing home's and hospital's franchise permit fee in accordance with division (A) or (B) of section 5168.42 of the Revised Code with the following changes:
(a) In the case of a nursing home or hospital for which one or more bed surrenders occurred during the period beginning on the first day of May of the preceding calendar year and ending on the first day of January of the calendar year in which the redetermination is made, the number of beds included in the calculation for the purpose of division (A)(1) or (B)(1) of section 5168.42 of the Revised Code shall exclude the beds for which bed surrenders occurred during that period.
(b) The number of days used in the calculation under division (A)(2) or (B)(2) of section 5168.42 of the Revised Code shall be the number of days in the first half of the calendar year in which the redetermination is made.
(c) The franchise permit fee rate shall reflect adjustments made under sections 5168.44 and 5168.45 of the Revised Code.
(C) Not later than the first day of March of each year, the department shall notify, electronically or by United States postal service, each nursing home and hospital of the amount of its redetermined franchise permit fee.
(D) Each nursing home and hospital shall pay its redetermined fee to the department in two installment payments not later than forty-five days after the last day of March and June of the calendar year in which the redetermination is made.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.49 | Change of Operator; Division of Franchise Permit Fees.

Effective:
September 29, 2015
Latest Legislation:
House Bill 64 - 131st General Assembly
If a nursing home or hospital undergoes a change of operator during a fiscal year, the responsibility for paying the franchise permit fee that was determined for the nursing home or hospital under section 5168.47 of the Revised Code, or redetermined for the nursing home or hospital under section 5168.48 of the Revised Code, for that fiscal year shall be divided proportionally. The exiting operator shall be responsible for paying the amount of the fee that is for the part of the fiscal year that ends on the day before the effective date of the change of operator. The entering operator shall be responsible for paying the amount of the fee that is for the part of the fiscal year that begins on the effective date of the change of operator. The department of medicaid is not required to notify the entering operator regarding the amount of that fiscal year's fee for which the entering operator is responsible.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.50 | Direct Billing for Franchise Permit Fee Prohibited.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
No nursing home or hospital shall directly bill its residents for the franchise permit fee paid under section 5168.47 or 5168.48 of the Revised Code or otherwise directly pass the fee through to its residents.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.51 | Assessment for Past Due Fee Installment.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
If a nursing home or hospital fails to pay the full amount of a franchise permit fee installment when due, the department of medicaid may assess a five per cent penalty on the amount due for each month or fraction thereof the installment is overdue.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.52 | Additional Sanctions for Past Due Fee Installment.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
(A) In addition to assessing a penalty pursuant to section 5168.51 of the Revised Code, the department of medicaid may do any of the following if a nursing facility or hospital fails to pay the full amount of a franchise permit fee installment when due:
(1) Withhold an amount less than or equal to the installment and penalty assessed under section 5168.51 of the Revised Code from a medicaid payment due the nursing facility or hospital until the nursing facility or hospital pays the installment and penalty;
(2) Offset an amount less than or equal to the installment and penalty assessed under section 5168.51 of the Revised Code from a medicaid payment due the nursing facility or hospital;
(3) Terminate the nursing facility or hospital's medicaid provider agreement.
(B) The department may offset a medicaid payment under division (A) of this section without providing notice to the nursing facility or hospital and without conducting an adjudication under Chapter 119. of the Revised Code.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.53 | Appeals.

Effective:
September 29, 2015
Latest Legislation:
House Bill 64 - 131st General Assembly
(A) A nursing home or hospital may appeal the fee assessed under section 5168.42 of the Revised Code, as adjusted under section 5168.44 or 5168.45 of the Revised Code, and redetermined under section 5168.48 of the Revised Code solely on the grounds that the department of medicaid committed a material error in determining or redetermining the amount of the fee. A request for an appeal must be received by the department not later than fifteen days after the date the department notifies the nursing home or hospital of the fee and must include written materials setting forth the basis for the appeal.
(B) If a nursing home or hospital submits a request for an appeal within the time required under division (A) of this section, the department shall hold a public hearing in Columbus not later than thirty days after the date the department receives the request for an appeal. The department shall, not later than ten days before the date of the hearing, notify, electronically or by United States postal service, the nursing home or hospital of the date, time, and place of the hearing. The department may hear all the requested appeals in one public hearing.
(C) On the basis of the evidence presented at the hearing or any other evidence submitted by the nursing home or hospital, the department may adjust a fee. The department's decision is final.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.54 | Nursing Home Franchise Permit Fee Fund.

Effective:
October 3, 2023
Latest Legislation:
House Bill 33 - 135th General Assembly
(A) There is hereby created in the state treasury the nursing home franchise permit fee fund. All payments and penalties paid by nursing homes and hospitals under sections 5168.47, 5168.48, and 5168.51 of the Revised Code shall be deposited into the fund. The fund shall also consist of money deposited into it pursuant to sections 3769.08 and 3769.26 of the Revised Code. Subject to division (B) of section 3769.08 of the Revised Code, the department of medicaid shall use the money in the fund to make medicaid payments to providers of nursing facility services and providers of home and community-based services, and to fund expanding the state ombudsman long-term care program and resident and family surveys at the department of aging, the addition of surveyors at the department of health, and to fund quality and consumer information resources. Money in the fund may also be used for the residential state supplement program established under section 5119.41 of the Revised Code.
(B) Any money remaining in the nursing home franchise permit fee fund after payments specified in division (A) of this section are made shall be retained in the fund. Any interest or other investment proceeds earned on money in the fund shall be credited to the fund and used to make medicaid payments in accordance with division (A) of this section.
Last updated September 5, 2023 at 3:42 PM
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.55 | Investigations; Enforcement.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
The department of medicaid may make any investigation it considers appropriate to obtain information necessary to fulfill its duties under sections 5168.40 to 5168.56 of the Revised Code. At the request of the department, the attorney general shall aid in any such investigations. The attorney general shall institute and prosecute all necessary actions for the enforcement of sections 5168.40 to 5168.56 of the Revised Code, except that at the request of the attorney general, the county prosecutor of the county in which a nursing home or hospital that has failed to comply with sections 5168.40 to 5168.56 of the Revised Code is located shall institute and prosecute any necessary action against the nursing home or hospital.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.56 | Implementing Provisions.

Effective:
September 29, 2013
Latest Legislation:
House Bill 59 - 130th General Assembly
The medicaid director shall adopt rules in accordance with Chapter 119. of the Revised Code to do both of the following:
(A) Prescribe the actions the department of medicaid will take to cease implementation of sections 5168.40 to 5168.56 of the Revised Code if the United States centers for medicare and medicaid services determines that the franchise permit fee established by those sections is an impermissible health-care related tax under the "Social Security Act," section 1903(w), 42 U.S.C. 1396b(w);
(B) Establish any requirements or procedures the director considers necessary to implement sections 5168.40 to 5168.56 of the Revised Code.
2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees › Section 5168.60 | Definitions for r.c. 5168.60 to 5168.71.

Effective:
September 30, 2021
Latest Legislation:
House Bill 110 - 134th General Assembly
As used in sections 5168.60 to 5168.71 of the Revised Code:
(A) Unless modified under division (C)(2) of section 5168.61 of the Revised Code, "franchise permit fee rate" means the following:
(1) For fiscal year 2020, twenty-three dollars and ninety-five cents;
(2) For fiscal year 2021 and each fiscal year thereafter, twenty-four dollars and eighty-nine cents.
(B) "Indirect guarantee percentage" means the percentage specified in the "Social Security Act," section 1903(w)(4)(C)(ii), 42 U.S.C. 1396b(w)(4)(C)(ii), that is to be used in determining whether a class of providers is indirectly held harmless for any portion of the costs of a broad-based health-care-related tax. If the indirect guarantee percentage changes during a fiscal year, the indirect guarantee percentage is the following:
(1) For the part of the fiscal year before the change takes effect, the percentage in effect before the change;
(2) For the part of the fiscal year beginning with the date the indirect guarantee percentage changes, the new percentage.
(C) "ICF/IID" has the same meaning as in section 5124.01 of the Revised Code.
(D) Except as provided in division (B) of section 5168.62 of the Revised Code, "inpatient days" has the same meaning as in section 5124.01 of the Revised Code.
(E) "Medicaid-certified capacity" has the same meaning as in section 5124.01 of the Revised Code.
(F) "Provider agreement" has the same meaning as in section 5124.01 of the Revised Code.
Last updated September 8, 2021 at 5:24 PM