Effective: September 29, 2017
Latest Legislation: House Bill 49 - 132nd General Assembly
(A) As used in sections 5166.40 to 5166.409 of the Revised Code:
(1) "Adult" means an individual who is at least eighteen years of age.
(2) "Buckeye account" means a modified health savings account established under section 5166.402 of the Revised Code.
(3) "Contribution" means the amounts that an individual contributes to the individual's buckeye account and are contributed to the account on the individual's behalf under divisions (C) and (D) of section 5166.402 of the Revised Code. "Contribution" does not mean the portion of an individual's buckeye account that consists of medicaid funds deposited under division (B) of section 5166.402 of the Revised Code or section 5166.404 of the Revised Code.
(4) "Core portion" means the portion of a healthy Ohio program participant's buckeye account that consists of the following:
(a) The amount of contributions to the account;
(b) The amounts awarded to the account under divisions (C) and (D) of section 5166.404 of the Revised Code.
(5) "Eligible employer-sponsored health plan" has the same meaning as in section 5000A(f)(2) of the "Internal Revenue Code of 1986," 26 U.S.C. 5000A(f)(2).
(6) "Healthy Ohio program" means the medicaid waiver component established under sections 5166.40 to 5166.409 of the Revised Code under which medicaid recipients specified in division (B) of this section enroll in comprehensive health plans and contribute to buckeye accounts.
(7) "Healthy Ohio program debit swipe card" means a debit swipe card issued by a managed care organization to a healthy Ohio program participant under section 5166.403 of the Revised Code.
(8) "Not-for-profit organization" means an organization that is exempt from federal income taxation under section 501(a) and (c)(3) of the "Internal Revenue Code of 1986," 26 U.S.C. 501(a) and (c)(3).
(9) "Ward of the state" means an individual who is a ward, as defined in section 2111.01 of the Revised Code.
(10) "Workforce development activity" and "local board" have the same meanings as in section 6301.01 of the Revised Code.
(B) The medicaid director shall establish a medicaid waiver component to be known as the healthy Ohio program. Each adult medicaid recipient, other than a ward of the state, determined to be eligible for medicaid on the basis of either of the following shall participate in the healthy Ohio program:
(1) On the basis of being included in the category identified by the department of medicaid as covered families and children;
(2) On the basis of being included in the expansion eligibility group.
(C) Except as provided in section 5166.406 of the Revised Code, a healthy Ohio program participant shall not receive medicaid services under the fee-for-service component of medicaid or participate in the care management system.
Structure Ohio Revised Code
Chapter 5166 | Federal Medicaid Waiver Programs
Section 5166.01 | Definitions.
Section 5166.02 | Rules Governing Medicaid Waiver Components.
Section 5166.03 | Notice of Intent to Request Medicaid Waiver.
Section 5166.04 | Home and Community-Based Services Medicaid Waiver Components.
Section 5166.05 | Review of Plans of Care and Individual Service Plans.
Section 5166.06 | Agency Records of Costs of Medicaid Waiver Components.
Section 5166.07 | Agency Accountable for Medicaid Waiver Components Funds.
Section 5166.08 | Agency Contracting for Medicaid Waiver Components; Assurance of Compliance.
Section 5166.10 | Transfer of Enrollee in One Medicaid Waiver Component to Another.
Section 5166.12 | Determination Regarding Continuation of the Ohio Home Care Waiver Program.
Section 5166.121 | Home First Component for the Ohio Home Care Waiver Program.
Section 5166.14 | Unified Long-Term Services and Support Medicaid Waiver Component.
Section 5166.16 | Integrated Care Delivery System Medicaid Waiver.
Section 5166.161 | Home and Community-Based Services for Holocaust Survivors.
Section 5166.20 | Additional Medicaid Waiver Components for Home and Community-Based Services.
Section 5166.21 | Transitions Developmental Disabilities Waiver.
Section 5166.22 | Allocating Enrollment Numbers to County Board of Developmental Disabilities.
Section 5166.30 | Coverage of Home Care Attendant Services.
Section 5166.301 | Home Care Attendant Services Providers.
Section 5166.302 | Continuing Education Requirements for Home Care Attendants.
Section 5166.303 | Responsibilities of Home Care Attendants.
Section 5166.304 | Nursing Assistance by Home Care Attendants.
Section 5166.305 | Nursing Assistance by Home Care Attendants; Consent and Authorization.
Section 5166.306 | Nursing Assistance by Home Care Attendants; Written Statement Providing Consent.
Section 5166.307 | Nursing Assistance by Home Care Attendants; Written Statement of Authorization.
Section 5166.308 | Nursing Assistance by Home Care Attendants; Unauthorized Actions.
Section 5166.3010 | Authorized Representative.
Section 5166.32 | Medicaid Waiver for Individuals With Cystic Fibrosis.
Section 5166.40 | Definitions.
Section 5166.401 | Enrolllment for Healthy Ohio Program Participants.
Section 5166.402 | Buckeye Accounts for Participants.
Section 5166.403 | Debit Swipe Cards.
Section 5166.404 | Points Award System.
Section 5166.405 | Cessation of Participation.
Section 5166.406 | Exhaustion of Payout Limits.
Section 5166.407 | Disqualification for Medicaid; Disposition of Remainder in Buckeye Account.
Section 5166.408 | Referral to Workforce Development Agency.