Medicaid State Plan Services | Midpage

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Ohio Revised Code

Chapter 5164

Medicaid State Plan Services

5164.01Definitions 5164.02Rules to implement chapter 5164.03Mandatory and optional services 5164.06Medicaid coverage of occupational therapy services 5164.061Chiropractic services 5164.07Coverage of inpatient care and follow-up care for a mother and her newborn 5164.071Doula program 5164.072Coverage of donor breast milk and fortifiers 5164.08Breast cancer and cervical cancer screening 5164.09Equivalent coverage for orally and intravenously administered cancer medications 5164.091Coverage for opioid analgesics 5164.092Coverage of remote ultrasounds and fetal nonstress tests 5164.093Coverage of rapid whole genome sequencing 5164.10Coverage of tobacco cessation medications and services 5164.14Medicaid coverage for health care service provided by pharmacist 5164.15Mental health services 5164.16Coverage of one or more state plan home and community-based services 5164.17Medicaid coverage of tobacco cessation services 5164.20Medicaid not to cover drugs for erectile dysfunction 5164.25Recipient with developmental disability who is eligible for medicaid case management services 5164.26Healthcheck component 5164.29Revised Medicaid provider enrollment system 5164.291Provider credentialing committee 5164.30Provider agreement with department required 5164.301Medicaid provider agreements for physician assistants 5164.31Funding for implementing the provider screening requirements 5164.32Expiration of medicaid provider agreements 5164.33Denying, terminating, and suspending provider agreements 5164.34Criminal records check of provider personnel, owners and officers 5164.341Criminal records check by independent provider 5164.342Criminal records checks by waiver agencies 5164.35Provider offenses 5164.36Credible allegation of fraud or disqualifying indictment; suspension of provider agreement 5164.37Suspension of provider agreement without notice 5164.38Adjudication orders of department 5164.39Hearing not required unless timely requested 5164.44Employee status of independent provider 5164.45Contracts for examination, processing, and determination of medicaid claims 5164.46Electronic claims submission process; electronic fund transfers 5164.47Contracting for review and analysis, quality assurance and quality review 5164.471Summary data regarding perinatal services 5164.48Medicaid payments made to organization on behalf of providers 5164.55Final fiscal audits 5164.56Lien for amount owed by provider 5164.57Recovery of medicaid overpayments 5164.58Agency action to recover overpayment to provider 5164.59Deduction of incorrect payments 5164.60Interest on Medicaid provider excess payments 5164.61Scope of available remedies for recovery of excess payments 5164.70Limitations on medicaid payments for services 5164.71Payments for freestanding medical laboratory charges 5164.72Limitations on payments for inpatient hospital care 5164.721Claims by freestanding birthing centers 5164.73Division of payments between physician or podiatrist and nurse 5164.74Reimbursement of graduate medical education costs 5164.741Payment for graduate medical education costs to noncontracting hospitals 5164.75Medicaid payment for a drug subject to a federal upper reimbursement limit 5164.751State maximum allowable cost program 5164.752Determining maximum dispensing fee 5164.753Dispensing fee 5164.754Agreement for multiple-state drug purchasing program 5164.755Supplemental drug rebate program 5164.756Drug rebate agreement or supplemental drug rebate agreement for medicaid program not subject to public records law 5164.757E-prescribing applications 5164.758Adoption of rules for implementation of coordinated services program for medicaid users who abuse prescription drugs 5164.759Outpatient drug use review program 5164.7510Pharmacy and therapeutics committee 5164.7511Medication synchronization for medicaid recipients 5164.7512Definitions for sections 5164.7512 to 5164.7514 5164.7514Step therapy exemption process 5164.7515Annual benchmark for prescribed drug spending growth 5164.76Manner of payment for community mental health service providers or facilities and alcohol and drug addiction services 5164.761Beta testing of updates to billing codes or payment rates 5164.78Medicaid payment rates for certain neonatal and newborn services 5164.80Public notice for changes to payment rates for medicaid assistance 5164.82Payment for provider-preventable condition 5164.85Enrolling in group health plan 5164.86Qualified state long-term care insurance partnership program 5164.88Coordinated care through health homes 5164.881Health home services 5164.89Case management of nonemergency transportation services 5164.90Transition of medicaid recipients to community settings 5164.91Integrated care delivery system 5164.911Integrated care delivery system evaluation 5164.912Integrated care delivery system standardized claim form 5164.913Home health aide and personal care aide training 5164.92Advanced diagnostic imaging services coverage under medicaid program 5164.93Incentive payments for adoption and use of electronic health record technology 5164.94Delivery of services in culturally and linguistically appropriate manners 5164.95Standards for payments for telehealth services; eligible practitioners 5164.951Standards for medicaid payments for services provided through teledentistry 5164.96Ground emergency medical transportation supplemental payment program