Ohio Revised Code|Chapter 5164 | Medicaid State Plan Services

Section 5164.01 | Definitions.

Section 5164.02 | Rules to implement chapter.

Section 5164.03 | Mandatory and optional services.

Section 5164.05 | Coverage of services provided by outpatient health facilities.

Section 5164.06 | Medicaid coverage of occupational therapy services.

Section 5164.07 | Coverage of inpatient care and follow-up care for a mother and her newborn.

Section 5164.08 | Screening mammography and cytologic screening for cervical cancer.

Section 5164.09 | Equivalent coverage for orally and intravenously administered cancer medications.

Section 5164.091 | Coverage for opioid analgesics.

Section 5164.10 | Coverage of tobacco cessation medications and services.

Section 5164.14 | Medicaid coverage for health care service provided by pharmacist.

Section 5164.15 | Mental health services.

Section 5164.16 | Coverage of one or more state plan home and community-based services.

Section 5164.17 | Medicaid coverage of tobacco cessation services.

Section 5164.20 | Medicaid not to cover drugs for erectile dysfunction.

Section 5164.25 | Recipient with developmental disability who is eligible for medicaid case management services.

Section 5164.26 | Healthcheck component.

Section 5164.29 | Revised Medicaid provider enrollment system.

Section 5164.30 | Provider agreement with department required.

Section 5164.301 | Medicaid provider agreements for physician assistants.

Section 5164.31 | Funding for implementing the provider screening requirements.

Section 5164.32 | Expiration of medicaid provider agreements.

Section 5164.33 | Denying, terminating, and suspending provider agreements.

Section 5164.34 | Criminal records check of provider personnel, owners and officers.

Section 5164.341 | Criminal records check by independent provider.

Section 5164.342 | Criminal records checks by waiver agencies.

Section 5164.35 | Provider offenses.

Section 5164.36 | Credible allegation of fraud or disqualifying indictment; suspension of provider agreement.

Section 5164.37 | Suspension of provider agreement without notice.

Section 5164.38 | Adjudication orders of department.

Section 5164.39 | Hearing not required unless timely requested.

Section 5164.44 | Employee status of independent provider.

Section 5164.45 | Contracts for examination, processing, and determination of medicaid claims.

Section 5164.46 | Electronic claims submission process; electronic fund transfers.

Section 5164.47 | Contracting for review and analysis, quality assurance and quality review.

Section 5164.471 | Summary data regarding perinatal services.

Section 5164.48 | Medicaid payments made to organization on behalf of providers.

Section 5164.55 | Final fiscal audits.

Section 5164.56 | Lien for amount owed by provider.

Section 5164.57 | Recovery of medicaid overpayments.

Section 5164.58 | Agency action to recover overpayment to provider.

Section 5164.59 | Deduction of incorrect payments.

Section 5164.60 | Interest on Medicaid provider excess payments.

Section 5164.61 | Scope of available remedies for recovery of excess payments.

Section 5164.70 | Limitations on medicaid payments for services.

Section 5164.71 | Payments for freestanding medical laboratory charges.

Section 5164.72 | Limitations on payments for inpatient hospital care.

Section 5164.721 | Claims by freestanding birthing centers.

Section 5164.73 | Division of payments between physician or podiatrist and nurse.

Section 5164.74 | Reimbursement of graduate medical education costs.

Section 5164.741 | Payment for graduate medical education costs to noncontracting hospitals.

Section 5164.75 | Medicaid payment for a drug subject to a federal upper reimbursement limit.

Section 5164.751 | State maximum allowable cost program.

Section 5164.752 | Determining maximum dispensing fee.

Section 5164.753 | Dispensing fee.

Section 5164.754 | Agreement for multiple-state drug purchasing program.

Section 5164.755 | Supplemental drug rebate program.

Section 5164.756 | Drug rebate agreement or supplemental drug rebate agreement for medicaid program not subject to public records law.

Section 5164.757 | E-prescribing applications.

Section 5164.758 | Adoption of rules for implementation of coordinated services program for medicaid users who abuse prescription drugs.

Section 5164.759 | Outpatient drug use review program.

Section 5164.7510 | Pharmacy and therapeutics committee.

Section 5164.7511 | Medication synchronization for medicaid recipients.

Section 5164.7512 | Definitions for sections 5164.7512 to 5164.7514.

Section 5164.7514 | Step therapy exemption process.

Section 5164.7515 | Annual benchmark for prescribed drug spending growth.

Section 5164.76 | Manner of payment for community mental health service providers or facilities and alcohol and drug addiction services.

Section 5164.761 | Beta testing of updates to billing codes or payment rates.

Section 5164.78 | Medicaid payment rates for certain neonatal and newborn services.

Section 5164.80 | Public notice for changes to payment rates for medicaid assistance.

Section 5164.82 | Payment for provider-preventable condition.

Section 5164.85 | Enrolling in group health plan.

Section 5164.86 | Qualified state long-term care insurance partnership program.

Section 5164.88 | Coordinated care through health homes.

Section 5164.881 | Health home services.

Section 5164.89 | Case management of nonemergency transportation services.

Section 5164.90 | Transition of medicaid recipients to community settings.

Section 5164.91 | Integrated care delivery system.

Section 5164.911 | Integrated care delivery system evaluation.

Section 5164.912 | Integrated care delivery system standardized claim form.

Section 5164.92 | Advanced diagnostic imaging services coverage under medicaid program.

Section 5164.93 | Incentive payments for adoption and use of electronic health record technology.

Section 5164.94 | Delivery of services in culturally and linguistically appropriate manners.

Section 5164.95 | Standards for payments for telehealth services.

Section 5164.951 | Standards for medicaid payments for services provided through teledentistry.