Ohio Revised Code
Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services
Section 5124.525 | Determination of Debt of Exiting Operator; Summary Report.

Effective: September 29, 2013
Latest Legislation: House Bill 59 - 130th General Assembly
The department of developmental disabilities shall determine the actual amount of debt an exiting operator owes the department and the United States centers for medicare and medicaid services under the medicaid program by completing all final fiscal audits not already completed and performing all other appropriate actions the department determines to be necessary. The department shall issue an initial debt summary report on this matter not later than sixty days after the date the exiting operator files the properly completed cost report required by section 5124.522 of the Revised Code with the department or, if the department waives the cost report requirement for the exiting operator, sixty days after the date the department waives the cost report requirement. The initial debt summary report becomes the final debt summary report thirty-one days after the department issues the initial debt summary report unless the exiting operator, or an affiliated operator who executes a successor liability agreement under section 5124.521 of the Revised Code, requests a review before that date.
The exiting operator, and an affiliated operator who executes a successor liability agreement under section 5124.521 of the Revised Code, may request a review to contest any of the department's findings included in the initial debt summary report. The request for the review must be submitted to the department not later than thirty days after the date the department issues the initial debt summary report. The department shall conduct the review on receipt of a timely request and issue a revised debt summary report. If the department has withheld money from payment due the exiting operator under division (A) of section 5124.521 of the Revised Code, the department shall issue the revised debt summary report not later than ninety days after the date the department receives the timely request for the review unless the department and exiting operator or affiliated operator agree to a later date. The exiting operator or affiliated operator may submit information to the department explaining what the operator contests before and during the review, including documentation of the amount of any debt the department owes the operator. The exiting operator or affiliated operator may submit additional information to the department not later than thirty days after the department issues the revised debt summary report. The revised debt summary report becomes the final debt summary report thirty-one days after the department issues the revised debt summary report unless the exiting operator or affiliated operator timely submits additional information to the department. If the exiting operator or affiliated operator timely submits additional information to the department, the department shall consider the additional information and issue a final debt summary report not later than sixty days after the department issues the revised debt summary report unless the department and exiting operator or affiliated operator agree to a later date.
Each debt summary report the department issues under this section shall include the department's findings and the amount of debt the department determines the exiting operator owes the department and United States centers for medicare and medicaid services under the medicaid program. The department shall explain its findings and determination in each debt summary report.
The exiting operator, and an affiliated operator who executes a successor liability agreement under section 5124.521 of the Revised Code, may request, in accordance with Chapter 119. of the Revised Code, an adjudication regarding a finding in a final debt summary report that pertains to an audit or alleged overpayment made under the medicaid program to the exiting operator. The adjudication shall be consolidated with any other uncompleted adjudication that concerns a matter addressed in the final debt summary report.

Structure Ohio Revised Code

Ohio Revised Code

Title 51 | Public Welfare

Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services

Section 5124.01 | Definitions.

Section 5124.02 | Assumption of Powers and Duties Regarding Medicaid Program's Coverage of Icf/iid Services.

Section 5124.03 | Rules.

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 5124.109 | Audits.

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 5124.153 | Payment Rate for Services Provided to Resident Who Meets Criteria for Admission to 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 5124.25 | Payment of Medicaid Rate Add-on for Outlier Services Provided for Ventilator-Dependent Residents.

Section 5124.26 | Payment of Medicaid Rate Add-on for Outlier Icf/iid Services.

Section 5124.29 | Limiting Compensation of Owners, Their Relatives, Administrators, and Resident Meals Outside Facility.

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 5124.44 | Deductions.

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 5124.68 | Admission as Resident in an Icf/iid With Medicaid-Certified Capacity Exceeding Eight.

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.