2006 Ohio Revised Code - 5111.85. Rules governing medicaid waiver components.

§ 5111.85. Rules governing medicaid waiver components.
 

(A)  As used in this section and sections 5111.851 [5111.85.1] to 5111.856 [5111.85.6] of the Revised Code, "medicaid waiver component" means a component of the medicaid program authorized by a waiver granted by the United States department of health and human services under section 1115 or 1915 of the "Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 1315 or 1396n. "Medicaid waiver component" does not include a care management system established under section 5111.16 of the Revised Code. 

(B)  The director of job and family services may adopt rules under Chapter 119. of the Revised Code governing medicaid waiver components that establish all of the following: 

(1) Eligibility requirements for the medicaid waiver components; 

(2) The type, amount, duration, and scope of services the medicaid waiver components provide; 

(3) The conditions under which the medicaid waiver components cover services; 

(4) The amount the medicaid waiver components pay for services or the method by which the amount is determined; 

(5) The manner in which the medicaid waiver components pay for services; 

(6) Safeguards for the health and welfare of medicaid recipients receiving services under a medicaid waiver component; 

(7) Procedures for enforcing the rules, including establishing corrective action plans for, and imposing financial and administrative sanctions on, persons and government entities that violate the rules. Sanctions shall include terminating medicaid provider agreements. The procedures shall include due process protections. 

(8) Other policies necessary for the efficient administration of the medicaid waiver components. 

(C)  The director of job and family services may adopt different rules for the different medicaid waiver components. The rules shall be consistent with the terms of the waiver authorizing the medicaid waiver component. 
 

HISTORY: 149 v H 94. Eff 9-5-2001; 150 v H 95, § 1, eff. 6-26-03; 151 v H 66, § 101.01, eff. 10-1-05.
 

The effective date is set by § 612.09 of 151 v H 66. 

The effective date is set by section 182 of H.B. 95 (150 v  - ). 

Not analogous to former RC § 5111.85 (145 v H 152; 145 v H 715; 146 v H 117), repealed 147 v H 215, § 224, eff 9-29-97.

The provisions of § 63.26 of HB 94 (149 v  - ) read as follows: 

SECTION 63.26. As used in this section, "Medicaid waiver component" has the same meaning as in section 5111.85 of the Revised Code. 

A rule adopted by the Director of Job and Family Services governing a Medicaid waiver component that is in effect on the effective date of this section shall remain in effect until amended or rescinded as part of the adoption of rules under section 5111.85 of the Revised Code. 

The rule of this act that items in uncodified sections do not have effect after June 30, 2003, does not apply to this section. 

 

Effect of Amendments

151 v H 66, effective October 1, 2005, in (A), inserted "and sections 5111.851 to 5111.856 of the Revised Code"; and deleted (D), pertaining to reviews of the medicaid waiver components. 

H.B. 95, Acts 2003, effective June 26, 2003, in (A), deleted "managed" preceding "care," inserted "management," and substituted "5111.16" for "5111.17."