Effective: October 17, 2019
Latest Legislation: House Bill 166 - 133rd General Assembly
(A) Before or during each program year, the department of medicaid shall mail to each hospital by certified mail, return receipt requested, the preliminary determination of the amount that the hospital is assessed under section 5168.06 of the Revised Code during the program year. The preliminary determination of a hospital's assessment shall be calculated for a cost-reporting period that is specified in rules adopted under section 5168.02 of the Revised Code.
The department shall consult with hospitals each year when determining the date on which it will mail the preliminary determinations in order to minimize hospitals' cash flow difficulties.
If no hospital submits a request for reconsideration under division (B) of this section, the preliminary determination constitutes the final reconciliation of each hospital's assessment under section 5168.06 of the Revised Code. The final reconciliation is subject to adjustments under division (D) of this section.
(B) Not later than fourteen days after the preliminary determinations are mailed, any hospital may submit to the department a written request to reconsider the preliminary determinations. The request shall be accompanied by written materials setting forth the basis for the reconsideration. If one or more hospitals submit a request, the department shall hold a public hearing not later than thirty days after the preliminary determinations are mailed to reconsider the preliminary determinations. The department shall mail to each hospital a written notice of the date, time, and place of the hearing at least ten days prior to the hearing. On the basis of the evidence submitted to the department or presented at the public hearing, the department shall reconsider and may adjust the preliminary determinations. The result of the reconsideration is the final reconciliation of the hospital's assessment under section 5168.06 of the Revised Code. The final reconciliation is subject to adjustments under division (D) of this section.
(C) The department shall mail to each hospital a written notice of its assessment for the program year under the final reconciliation. A hospital may appeal the final reconciliation of its assessment to the court of common pleas of Franklin county. While a judicial appeal is pending, the hospital shall pay, in accordance with the schedules required by division (B) of section 5168.06 of the Revised Code, any amount of its assessment that is not in dispute into the hospital care assurance program fund created in section 5168.11 of the Revised Code.
(D) In the course of any program year, the department may adjust the assessment rate or rates established in rules pursuant to section 5168.06 of the Revised Code or adjust the amounts of intergovernmental transfers required under section 5168.07 of the Revised Code and, as a result of the adjustment, adjust each hospital's assessment and intergovernmental transfer, to reflect refinements made by the United States centers for medicare and medicaid services during that program year to the limits it prescribed under the "Social Security Act," section 1923(f), 42 U.S.C. 1396r-4(f). When adjusted, the assessment rate or rates must comply with division (A) of section 5168.06 of the Revised Code. An adjusted intergovernmental transfer must comply with division (A) of section 5168.07 of the Revised Code. The department shall notify hospitals of adjustments made under this division and adjust for the remainder of the program year the installments paid by hospitals under sections 5168.06 and 5168.07 of the Revised Code in accordance with rules adopted under section 5168.02 of the Revised Code.
Last updated September 8, 2021 at 5:12 PM
Structure Ohio Revised Code
Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees
Section 5168.01 | [Repealed Effective 10/16/2023] Hospital Care Assurance Program Definitions.
Section 5168.02 | [Repealed Effective 10/16/2023] Adoption of Rules.
Section 5168.04 | [Repealed Effective 10/16/2023] Program Year Basis of Operation.
Section 5168.05 | [Repealed Effective 10/16/2023] Submitting Financial Statement and Cost Report.
Section 5168.06 | [Repealed Effective 10/16/2023] Annual Assessment.
Section 5168.08 | [Repealed Effective 10/16/2023] Preliminary Determination of Assessment.
Section 5168.11 | [Repealed Effective 10/16/2023] Hospital Care Assurance Program Fund.
Section 5168.13 | [Repealed Effective 10/16/2023] Confidentiality.
Section 5168.20 | [Repealed Effective 10/1/2023] Definitions for Sections 5168.20 to 5168.28.
Section 5168.21 | [Repealed Effective 10/1/2023] Additional Annual Assessment.
Section 5168.22 | [Repealed Effective 10/1/2023] Preliminary Determination of Assessment Amount.
Section 5168.23 | [Repealed Effective 10/1/2023] Assessment Payment Schedule.
Section 5168.24 | [Repealed Effective 10/1/2023] Audit.
Section 5168.25 | [Repealed Effective 10/1/2023] Hospital Assessment Fund.
Section 5168.26 | [Repealed Effective 10/1/2023] Excluded Costs.
Section 5168.40 | Franchise Permit Fee Definitions.
Section 5168.42 | Annual Franchise Permit Fee.
Section 5168.43 | Waiver of Franchise Permit Fee.
Section 5168.44 | Approval of Waiver; Reduction in Franchise Permit Fee Rate.
Section 5168.45 | Increase in Franchise Permit Fee Rate.
Section 5168.46 | Annual Reports.
Section 5168.47 | Determination, Notice, and Payment of Annual Fee.
Section 5168.48 | Redetermination of Franchise Permit Fees.
Section 5168.49 | Change of Operator; Division of Franchise Permit Fees.
Section 5168.50 | Direct Billing for Franchise Permit Fee Prohibited.
Section 5168.51 | Assessment for Past Due Fee Installment.
Section 5168.52 | Additional Sanctions for Past Due Fee Installment.
Section 5168.54 | Nursing Home Franchise Permit Fee Fund.
Section 5168.55 | Investigations; Enforcement.
Section 5168.56 | Implementing Provisions.
Section 5168.60 | Definitions for r.c. 5168.60 to 5168.71.
Section 5168.61 | Icf/iid Quarterly Franchise Permit Fees.
Section 5168.62 | Monthly Report.
Section 5168.63 | Determination, Notice and Payment of Quarterly Franchise Permit Fee.
Section 5168.64 | Consequences of Converting Beds to Providing Home and Community-Based Services.
Section 5168.65 | Assessing Penalty for Overdue Installment.
Section 5168.66 | Additional Sanctions for Overdue Installment.
Section 5168.67 | Appeal of Fee.
Section 5168.69 | Department of Developmental Disabilities Operating and Services Fund.
Section 5168.70 | Investigation; Enforcement.
Section 5168.71 | Adoption of Rules.
Section 5168.75 | Definitions for r.c. 5168.75 to 5168.86.
Section 5168.76 | Franchise Fee on Health Insuring Corporation Plans.
Section 5168.77 | Component Due Dates.
Section 5168.78 | Documentation.
Section 5168.79 | Determination of Higher Fee.
Section 5168.80 | Request for Reconsideration.
Section 5168.81 | Penalty for Overdue Payments.
Section 5168.82 | Waiver Required.
Section 5168.84 | Modification or Cessation.
Section 5168.85 | Health Insuring Corporation Franchise Fee Fund.
Section 5168.86 | Implementation.
Section 5168.90 | Quarterly Report to Jmoc.
Section 5168.99 | [Repealed Effective 10/16/2023] Penalties.
Section 5168.991 | [Repealed Effective 10/16/2023] Offsetting Unpaid Penalty.