Effective: December 31, 2017
Latest Legislation: House Bill 49 - 132nd General Assembly
The medicaid director shall adopt rules under section 5168.02 of the Revised Code establishing a methodology to pay hospitals that is sufficient to expend all money in the indigent care pool. Under the rules:
(A) The department of medicaid may classify similar hospitals into groups and allocate funds for distribution within each group.
(B) The department shall establish a method of allocating funds to hospitals, taking into consideration the relative amount of indigent care provided by each hospital or group of hospitals. The amount to be allocated shall be based on any combination of the following indicators of indigent care that the director considers appropriate:
(1) Total costs, volume, or proportion of services to recipients of the medical assistance program, including recipients enrolled in health insuring corporations;
(2) Total costs, volume, or proportion of services to low-income patients in addition to medicaid recipients, which may include recipients of Title V of the "Social Security Act," 42 U.S.C. 701 et seq.;
(3) The amount of uncompensated care provided by the hospital or group of hospitals;
(4) Other factors that the director considers to be appropriate indicators of indigent care.
(C) The department shall distribute funds to each hospital or group of hospitals in a manner that first may provide for an additional distribution to individual hospitals that provide a high proportion of indigent care in relation to the total care provided by the hospital or in relation to other hospitals. The department shall establish a formula to distribute the remainder of the funds. The formula shall be consistent with the "Social Security Act," section 1923, 42 U.S.C. 1396r-4, and shall be based on any combination of the indicators of indigent care listed in division (B) of this section that the director considers appropriate.
(D) The department shall distribute funds to each hospital in installments not later than ten working days after the deadline established in rules for each hospital to pay an installment on its assessment under section 5168.06 of the Revised Code. In the case of a governmental hospital that makes intergovernmental transfers, the department shall pay an installment under this section not later than ten working days after the earlier of that deadline or the deadline established in rules for the governmental hospital to pay an installment on its intergovernmental transfer. If the amount in the hospital care assurance program fund created under section 5168.11 of the Revised Code and the portion of the health care - federal fund created under section 5162.50 of the Revised Code that is credited to that fund pursuant to division (B) of section 5168.11 of the Revised Code are insufficient to make the total distributions for which hospitals are eligible to receive in any period, the department shall reduce the amount of each distribution by the percentage by which the amount and portion are insufficient. The department shall distribute to hospitals any amounts not distributed in the period in which they are due as soon as moneys are available in the funds.
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.