Ohio Revised Code
Chapter 5167 | Medicaid Managed Care
Section 5167.171 | Uniform Prior Approval Form for Progesterone.

Effective: October 17, 2019
Latest Legislation: House Bill 166 - 133rd General Assembly
Each medicaid managed care organization shall, if the organization requires practitioners to obtain prior approval before administering progesterone to the organization's enrollees who are pregnant, use a uniform prior approval form for progesterone that is not more than one page.

Structure Ohio Revised Code

Ohio Revised Code

Title 51 | Public Welfare

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 5167.122 | Disclosure of Sources of Payment.

Section 5167.123 | Medicaid Mco Contracts With 340b Program Participants.

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 5167.15 | Chiropractic Services.

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 5167.173 | 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 5167.26 | 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.

Section 5167.47 | Compliance With Federal Mental Health and Addiction Parity Laws.