2006 Ohio Revised Code - [5111.16.3] 5111.163.Emergency services by noncontracting providers.

[§ 5111.16.3] § 5111.163. Emergency services by noncontracting providers.
 

(A)  As used in this section: 

(1) "Emergency services" has the same meaning as in section 1932(b)(2) of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1396u-2(b)(2), as amended. 

(2) "Medicaid managed care organization" has the same meaning as in section 5111.162 [5111.16.2] of the Revised Code. 

(3) "Provider" has the same meaning as in section 5111.06 of the Revised Code. 

(B)  When a participant in the care management system established under section 5111.16 of the Revised Code is enrolled in a medicaid managed care organization and receives emergency services on or after January 1, 2007, from a provider that is not under contract with the organization, the provider shall accept from the organization, as payment in full, not more than the amounts (less any payments for indirect costs of medical education and direct costs of graduate medical education) that the provider could collect if the participant received medicaid other than through enrollment in a managed care organization. 
 

HISTORY: 151 v H 530, § 101.01, eff. 6-30-06.
 

The effective date is set by § 812.03 of 151 v H 530.