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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 5167 - MEDICAID MANAGED CARE
Chapter 5167 - MEDICAID MANAGED CARE
Section 5167.01 - Definitions.
Section 5167.02 - Rules.
Section 5167.03 - Care management system.
Section 5167.031 - Recognition of pediatric accountable care organizations.
Section 5167.04 - Inclusion of alcohol, drug addiction, and mental health services in care management system.
Section 5167.05 - Inclusion of prescribed drugs in care management system.
Section 5167.051 - Coverage of services provided by pharmacist.
Section 5167.10 - Authority to contract with managed care orgainizations.
Section 5167.101 - Basis of hospital inpatient capital payment portion of payment to medicaid managed care organization.
Section 5167.102 - Use of providers to render care to enrollees.
Section 5167.103 - Performance metrics; publication.
Section 5167.11 - Managed care organization contract to provide grievance process.
Section 5167.12 - Requirements when prescribed drugs are included in care management system.
Section 5167.121 - [Renumbered].
Section 5167.122 - Disclosure of sources of payment.
Section 5167.13 - Implementation of coordinated services program for enrollees who abuse prescribed drugs.
Section 5167.14 - Data security agreements for managed care organization's use of drug database.
Section 5167.16 - Home visits and cognitive behavioral therapy.
Section 5167.17 - Enhanced care management services for pregnant women and women capable of becoming pregnant.
Section 5167.171 - Uniform prior approval form for progesterone.
Section 5167.172 - Promotion of use of technology-based resources regarding healthy pregnancies and babies.
Section 5167.173 - Community health worker services or services provided by public health nurse.
Section 5167.18 - Identification of fraud, waste, and abuse.
Section 5167.20 - Reference by managed care organization to noncontracting participant.
Section 5167.201 - Payment of nonsystem provider for emergency services.
Section 5167.21 - Payments to skilled nursing facility.
Section 5167.22 - Recoupment of overpayment.
Section 5167.221 - Assessment of recoupment efforts.
Section 5167.24 - Third-party administrator as single pharmacy benefit manager.
Section 5167.241 - State pharmacy benefit manager contract; payment arrangements.
Section 5167.243 - Quarterly reports.
Section 5167.244 - Violations; penalty.
Section 5167.245 - Appeals process.
Section 5167.25 - [Repealed].
Section 5167.26 - Records for determining costs.
Section 5167.30 - Managed care performance payment program.
Section 5167.31 - Financial incentive awards.
Section 5167.32 - Improving integrity of care management system.
Section 5167.33 - Strategies regarding payment to providers.
Section 5167.34 - Immunity from liability.
Section 5167.40 - Appointment of temporary manager.
Section 5167.41 - Disenrolling some or all medicaid recipients from MCO plan offered by a managed care organization.
Section 5167.45 - Information about medicaid recipients' races, ethnicities, and primary languages.