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U.S. State Codes
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Ohio
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Title [51] LI PUBLIC WELFARE
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Chapter 5164 - MEDICAID STATE PLAN SERVICES
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 one or more state plan home and community-based services.
Section 5164.14 - Medicaid coverage for health care service provided by pharmacist.
Section 5164.15 - Mental health 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 - [Effective Until 3/22/2020] Medication synchronization for medicaid recipients.
Section 5164.7511 - [Effective 3/22/2020] Medication synchronization for medicaid recipients.
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 5164.77 - [Repealed].
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 - .
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.
Section 5164.7512 - Definitions for sections to 5164.7514.
Section 5164.7514 - Step therapy exemption process.
Section 5164.7515 - Annual benchmark for prescribed drug spending growth.