Effective: September 15, 2014
Latest Legislation: House Bill 483 - 130th General Assembly
(A) If an ICF/IID provider required by section 5124.10 of the Revised Code to file a cost report for the ICF/IID fails to file the cost report by the date it is due or the date, if any, to which the due date is extended pursuant to division (E) of that section, or files an incomplete or inadequate report for the ICF/IID under that section, the department of developmental disabilities shall do both of the following:
(1) Give written notice to the provider that the provider agreement for the ICF/IID will be terminated in thirty days unless the provider submits a complete and adequate cost report for the ICF/IID within thirty days;
(2) Reduce the per medicaid day payment rate for the provider's ICF/IID by the amount specified in division (B) of this section for the period of time specified in division (C) of this section.
(B) For the purpose of division (A)(2) of this section, an ICF/IID's per medicaid day payment rate shall be reduced by the following amount:
(1) In the case of a reduction made during the period beginning on the effective date of this amendment and ending on the first day of the first fiscal year beginning after the effective date of this amendment, two dollars;
(2) In the case of a reduction made during the first fiscal year beginning after the effective date of this amendment and each fiscal year thereafter, the amount of the reduction in effect on the last day of the fiscal year immediately preceding the fiscal year in which the reduction is made adjusted by the rate of inflation during that immediately preceding fiscal year, as shown in the consumer price index for all items for all urban consumers for the midwest region, published by the United States bureau of labor statistics.
(C) The period of time that an ICF/IID's per medicaid day payment rate is reduced under this section shall begin and end as follows:
(1) The period shall begin on the following date:
(a) The day immediately following the date the cost report is due or to which the due date is extended, as applicable, if the reduction is made because the provider fails to file a cost report by that date;
(b) The day the department gives the provider written notice under division (A)(1) of this section of the proposed provider agreement termination, if the reduction is made because the provider files an incomplete or inadequate cost report.
(2) The period shall end on the last day of the thirty-day period specified in the notice given under division (A)(1) of this section or any additional period allowed for an appeal of the proposed provider agreement termination.
Structure Ohio Revised Code
Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services
Section 5124.01 | Definitions.
Section 5124.05 | Scope of Coverage.
Section 5124.06 | Eligibility to Enter Into Provider Agreements.
Section 5124.07 | Department Provider Agreements; Contents.
Section 5124.071 | Agreements With More Than One Icf/iid.
Section 5124.072 | Revalidation of Agreements.
Section 5124.08 | Provider Agreements With Icf/iid Providers.
Section 5124.081 | Resident's Cause of Action for Breach.
Section 5124.10 | Cost Reports.
Section 5124.101 | Cost Reports for Downsized or Partially Converted Provider.
Section 5124.102 | Fines Paid Excluded From Reports.
Section 5124.103 | Form of Cost Reports.
Section 5124.104 | Duties of Department.
Section 5124.105 | Addendum for Disputed Costs.
Section 5124.106 | Failure to Timely File Report; Consequences.
Section 5124.107 | Amendments to Reports.
Section 5124.108 | Desk Review.
Section 5124.15 | Amount of Payments.
Section 5124.151 | Initial Rates for Services Provided by a New Icf/iid.
Section 5124.152 | Payment Rate for Service Provided by Outlier Icf/iid or Unit.
Section 5124.154 | Computing Rate for Services Provided by Developmental Centers.
Section 5124.17 | Icf/iid's per Medicaid Day Capital Component Rate.
Section 5124.19 | Icf/iid's per Medicaid Day Direct Care Costs Component Rate.
Section 5124.191 | Definition of Icf/iid Resident; Assessment of Residents.
Section 5124.192 | Acuity Groups for Purpose of Assigning Case-Mix Scores.
Section 5124.193 | Quarterly Determination of Case-Mix Scores.
Section 5124.194 | Changes to Instructions, Guidelines, or Methodology.
Section 5124.21 | Per Medicaid Day Indirect Care Costs Component Rate.
Section 5124.23 | Per Medicaid Day Other Protected Costs Component Rate.
Section 5124.24 | Determination of per Medicaid Day Quality Incentive Payment.
Section 5124.26 | Payment of Medicaid Rate Add-on for Outlier Icf/iid Services.
Section 5124.30 | Costs of Goods Furnished by Related Party.
Section 5124.31 | Adjustment of Payment Rates.
Section 5124.32 | Reduction in Rate Not Permitted.
Section 5124.33 | No Payment for Day of Discharge.
Section 5124.34 | Payment for Reserving Beds.
Section 5124.35 | Timing of Payments After Involuntary Termination.
Section 5124.37 | Timing of Payments; Calculations.
Section 5124.38 | Process for Reconsideration of Rates.
Section 5124.39 | Recoupment in Case of Delay in Downsizing.
Section 5124.40 | Adjustment of Rates.
Section 5124.41 | Redetermination of Rates.
Section 5124.42 | Additional Penalties.
Section 5124.43 | Determination of Interest Rate.
Section 5124.45 | Deposits to General Revenue Fund.
Section 5124.46 | Adjudications Under the Administrative Procedure Act.
Section 5124.50 | Notice of Facility Closure or Voluntary Termination.
Section 5124.51 | Notice of Change of Operator.
Section 5124.511 | Agreements With Entering Operators Effective on Date of Change of Operator.
Section 5124.512 | Agreements With Entering Operators Effective at a Later Date.
Section 5124.513 | Entering Operator Duties Under Provider Agreement.
Section 5124.514 | Exiting Operator Deemed Operator Pending Change.
Section 5124.515 | Provider Agreement With Operator Not Complying With Prior Agreement.
Section 5124.516 | Medicaid Reimbursement Adjustments; Change of Operator.
Section 5124.517 | Determination That a Change of Operator Has or Has Not Occurred; Effect.
Section 5124.52 | Overpayment Amounts Determined Following Notice of Closure, Etc.
Section 5124.521 | Withholding From Medicaid Payment Due Exiting Operator.
Section 5124.522 | Cost Report by Exiting Operator; Waiver.
Section 5124.523 | Failure to File Cost Report; Payments Deemed Overpayments.
Section 5124.524 | Final Payment Withheld Pending Receipt of Cost Reports.
Section 5124.525 | Determination of Debt of Exiting Operator; Summary Report.
Section 5124.526 | Release of Amount Withheld Less Amounts Owed.
Section 5124.527 | Release of Amount Withheld on Postponement of Change of Operator.
Section 5124.528 | Disposition of Amounts Withheld From Payment Due an Exiting Operator.
Section 5124.53 | Adoption of Rules for Implementation of Sections 5124.50 to 5124.53.
Section 5124.60 | Conversion of Beds to Home and Community-Based Services.
Section 5124.61 | Conversion of Beds in Acquired Icf/iid.
Section 5124.62 | Request for Federal Approval of Conversion of Beds.
Section 5124.65 | Reconversion of Beds to Icf/iid Use.
Section 5124.69 | Informational Pamphlet.
Section 5124.70 | Maximum Number of Residents per Sleeping Room.
Section 5124.99 | Penalty for Violation of Cost Reporting Provisions.