Ohio Revised Code
Title 51 | Public Welfare
Chapter 5164 | Medicaid State Plan Services

Section 5164.05 | Coverage of Services Provided by Outpatient Health Facilities. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.06 | Medicaid Coverage of Occupational Therapy Services. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.061 | Chiropractic Services. - Effective: June 13, 2022 Latest Legislation: House Bill 136 -...

Section 5164.07 | Coverage of Inpatient Care and Follow-Up Care for a Mother and Her Newborn. - Effective: April 6, 2017 Latest Legislation: House Bill 216 -...

Section 5164.08 | Breast Cancer and Cervical Cancer Screening. - Effective: September 23, 2022 Latest Legislation: House Bill 371 -...

Section 5164.09 | Equivalent Coverage for Orally and Intravenously Administered Cancer Medications. - Effective: January 1, 2015 Latest Legislation: Senate Bill 99 -...

Section 5164.091 | Coverage for Opioid Analgesics. - Effective: April 6, 2017 Latest Legislation: Senate Bill 319 -...

Section 5164.10 | Coverage of Tobacco Cessation Medications and Services. - Effective: September 18, 2020 Latest Legislation: House Bill 11 -...

Section 5164.14 | Medicaid Coverage for Health Care Service Provided by Pharmacist. - Effective: December 16, 2020 Latest Legislation: House Bill 203 -...

Section 5164.15 | Mental Health Services. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.16 | Coverage of One or More State Plan Home and Community-Based Services. - Effective: September 18, 2020 Latest Legislation: House Bill 11 -...

Section 5164.17 | Medicaid Coverage of Tobacco Cessation Services. - Effective: September 18, 2020 Latest Legislation: House Bill 11 -...

Section 5164.20 | Medicaid Not to Cover Drugs for Erectile Dysfunction. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.25 | Recipient With Developmental Disability Who Is Eligible for Medicaid Case Management Services. - Effective: October 12, 2016 Latest Legislation: House Bill 158 -...

Section 5164.26 | Healthcheck Component. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.29 | Revised Medicaid Provider Enrollment System. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5164.291 | Provider Credentialing Committee. - Effective: March 23, 2022 Latest Legislation: House Bill 122 -...

Section 5164.30 | Provider Agreement With Department Required. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.301 | Medicaid Provider Agreements for Physician Assistants. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.31 | Funding for Implementing the Provider Screening Requirements. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5164.32 | Expiration of Medicaid Provider Agreements. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.33 | Denying, Terminating, and Suspending Provider Agreements. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.34 | Criminal Records Check of Provider Personnel, Owners and Officers. - Effective: September 30, 2021 Latest Legislation: House Bill 110 -...

Section 5164.341 | Criminal Records Check by Independent Provider. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5164.342 | Criminal Records Checks by Waiver Agencies. - Effective: September 30, 2021 Latest Legislation: House Bill 110 -...

Section 5164.35 | Provider Offenses. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.36 | Credible Allegation of Fraud or Disqualifying Indictment; Suspension of Provider Agreement. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5164.37 | Suspension of Provider Agreement Without Notice. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5164.38 | Adjudication Orders of Department. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5164.39 | Hearing Not Required Unless Timely Requested. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.44 | Employee Status of Independent Provider. - Effective: March 23, 2016 Latest Legislation: House Bill 56 -...

Section 5164.45 | Contracts for Examination, Processing, and Determination of Medicaid Claims. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.46 | Electronic Claims Submission Process; Electronic Fund Transfers. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.47 | Contracting for Review and Analysis, Quality Assurance and Quality Review. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.471 | Summary Data Regarding Perinatal Services. - Effective: April 6, 2017 Latest Legislation: Senate Bill 332 -...

Section 5164.48 | Medicaid Payments Made to Organization on Behalf of Providers. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.55 | Final Fiscal Audits. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.56 | Lien for Amount Owed by Provider. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.57 | Recovery of Medicaid Overpayments. - Effective: September 29, 2015 Latest Legislation: House Bill 64 -...

Section 5164.58 | Agency Action to Recover Overpayment to Provider. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.59 | Deduction of Incorrect Payments. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.60 | Interest on Medicaid Provider Excess Payments. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.61 | Scope of Available Remedies for Recovery of Excess Payments. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.70 | Limitations on Medicaid Payments for Services. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5164.71 | Payments for Freestanding Medical Laboratory Charges. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.72 | Limitations on Payments for Inpatient Hospital Care. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.721 | Claims by Freestanding Birthing Centers. - Effective: April 6, 2017 Latest Legislation: Senate Bill 332 -...

Section 5164.73 | Division of Payments Between Physician or Podiatrist and Nurse. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.74 | Reimbursement of Graduate Medical Education Costs. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.741 | Payment for Graduate Medical Education Costs to Noncontracting Hospitals. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.75 | Medicaid Payment for a Drug Subject to a Federal Upper Reimbursement Limit. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.751 | State Maximum Allowable Cost Program. - Effective: April 12, 2021 Latest Legislation: Senate Bill 263 -...

Section 5164.752 | Determining Maximum Dispensing Fee. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5164.753 | Dispensing Fee. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5164.754 | Agreement for Multiple-State Drug Purchasing Program. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.755 | Supplemental Drug Rebate Program. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.756 | Drug Rebate Agreement or Supplemental Drug Rebate Agreement for Medicaid Program Not Subject to Public Records Law. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.757 | E-Prescribing Applications. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.758 | Adoption of Rules for Implementation of Coordinated Services Program for Medicaid Users Who Abuse Prescription Drugs. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.759 | Outpatient Drug Use Review Program. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.7510 | Pharmacy and Therapeutics Committee. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5164.7511 | Medication Synchronization for Medicaid Recipients. - Effective: March 22, 2020 Latest Legislation: Senate Bill 229 -...

Section 5164.7512 | Definitions for Sections 5164.7512 to 5164.7514. - Effective: April 5, 2019 Latest Legislation: Senate Bill 265 -...

Section 5164.7514 | Step Therapy Exemption Process. - Effective: April 5, 2019 Latest Legislation: Senate Bill 265 -...

Section 5164.7515 | Annual Benchmark for Prescribed Drug Spending Growth. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5164.76 | Manner of Payment for Community Mental Health Service Providers or Facilities and Alcohol and Drug Addiction Services. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.761 | Beta Testing of Updates to Billing Codes or Payment Rates. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5164.78 | Medicaid Payment Rates for Certain Neonatal and Newborn Services. - Effective: November 22, 2017 Latest Legislation: House Bill 49 -...

Section 5164.80 | Public Notice for Changes to Payment Rates for Medicaid Assistance. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.82 | Payment for Provider-Preventable Condition. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.85 | Enrolling in Group Health Plan. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.86 | Qualified State Long-Term Care Insurance Partnership Program. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.88 | Coordinated Care Through Health Homes. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.881 | Health Home Services. - Effective: October 12, 2016 Latest Legislation: House Bill 158 -...

Section 5164.89 | Case Management of Nonemergency Transportation Services. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.90 | Transition of Medicaid Recipients to Community Settings. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.91 | Integrated Care Delivery System. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.911 | Integrated Care Delivery System Evaluation. - Effective: March 20, 2014 Latest Legislation: Senate Bill 206 -...

Section 5164.912 | Integrated Care Delivery System Standardized Claim Form. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5164.92 | Advanced Diagnostic Imaging Services Coverage Under Medicaid Program. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.93 | Incentive Payments for Adoption and Use of Electronic Health Record Technology. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5164.94 | Delivery of Services in Culturally and Linguistically Appropriate Manners. - Effective: March 20, 2014 Latest Legislation: Senate Bill 206 -...

Section 5164.95 | Standards for Payments for Telehealth Services; Eligible Practitioners. - Effective: March 23, 2022 Latest Legislation: House Bill 122 -...

Section 5164.951 | Standards for Medicaid Payments for Services Provided Through Teledentistry. - Effective: March 20, 2019 Latest Legislation: Senate Bill 259 -...

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Ohio Revised Code Title 51 | Public Welfare Chapter 5164 | Medicaid State Plan Services

Ohio Revised Code
Title 51 | Public Welfare
Chapter 5164 | Medicaid State Plan Services