2011 Ohio Revised Code
Title [51] LI PUBLIC WELFARE
Chapter 5111: MEDICAL ASSISTANCE PROGRAMS
5111.225 Amount of payments for dual eligible individuals.
(A) As used in this section:
“Dual eligible individual” has the same meaning as in section 1915(h)(2)(B) of the “Social Security Act,” 124 Stat. 315 (2010), 42 U.S.C. 1396n(h)(2)(B).
“Medicaid maximum allowable amount” means one hundred per cent of a nursing facility’s per diem rate for a medicaid day.
(B) The department of job and family services shall pay the provider of a nursing facility the lesser of the following for nursing facility services the nursing facility provides on or after January 1, 2012, to a dual eligible individual who is eligible for nursing facility services under the medicaid program and post-hospital extended care services under Part A of Title XVIII:
(1) The coinsurance amount for the services as provided under Part A of Title XVIII;
(2) The medicaid maximum allowable amount for the services, less the amount paid under Part A of Title XVIII for the services.
Added by 129th General Assembly File No. 28, HB 153, § 101.01, eff. 9/29/2011.
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