Ohio Revised Code
Title 51 | Public Welfare
Chapter 5167 | Medicaid Managed Care

Section 5167.01 | Definitions. - Effective: April 12, 2021 Latest Legislation: Senate Bill 263 -...

Section 5167.02 | Rules. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5167.03 | Care Management System. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.031 | Recognition of Pediatric Accountable Care Organizations. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5167.04 | Inclusion of Alcohol, Drug Addiction, and Mental Health Services in Care Management System. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.05 | Inclusion of Prescribed Drugs in Care Management System. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.051 | Coverage of Services Provided by Pharmacist. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.10 | Authority to Contract With Managed Care Orgainizations. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.101 | Basis of Hospital Inpatient Capital Payment Portion of Payment to Medicaid Managed Care Organization. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.102 | Use of Providers to Render Care to Enrollees. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.103 | Performance Metrics; Publication. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.11 | Managed Care Organization Contract to Provide Grievance Process. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.12 | Requirements When Prescribed Drugs Are Included in Care Management System. - Effective: September 18, 2020 Latest Legislation: House Bill 11 -...

Section 5167.122 | Disclosure of Sources of Payment. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.123 | Medicaid Mco Contracts With 340b Program Participants. - Effective: April 12, 2021 Latest Legislation: Senate Bill 263 -...

Section 5167.13 | Implementation of Coordinated Services Program for Enrollees Who Abuse Prescribed Drugs. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.14 | Data Security Agreements for Managed Care Organization's Use of Drug Database. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.15 | Chiropractic Services. - Effective: June 13, 2022 Latest Legislation: House Bill 136 -...

Section 5167.16 | Home Visits and Cognitive Behavioral Therapy. - Effective: September 30, 2021 Latest Legislation: House Bill 110 -...

Section 5167.17 | Enhanced Care Management Services for Pregnant Women and Women Capable of Becoming Pregnant. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.171 | Uniform Prior Approval Form for Progesterone. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.173 | Community Health Worker Services or Services Provided by Public Health Nurse. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.18 | Identification of Fraud, Waste, and Abuse. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.20 | Reference by Managed Care Organization to Noncontracting Participant. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.201 | Payment of Nonsystem Provider for Emergency Services. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.21 | Payments to Skilled Nursing Facility. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5167.22 | Recoupment of Overpayment. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.221 | Assessment of Recoupment Efforts. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.24 | Third-Party Administrator as Single Pharmacy Benefit Manager. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.241 | State Pharmacy Benefit Manager Contract; Payment Arrangements. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.243 | Quarterly Reports. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.244 | Violations; Penalty. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.245 | Appeals Process. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.26 | Records for Determining Costs. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.30 | Managed Care Performance Payment Program. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5167.31 | Financial Incentive Awards. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5167.32 | Improving Integrity of Care Management System. - Effective: September 29, 2015 Latest Legislation: House Bill 64 -...

Section 5167.33 | Strategies Regarding Payment to Providers. - Effective: September 29, 2015 Latest Legislation: House Bill 64 -...

Section 5167.34 | Immunity From Liability. - Effective: September 29, 2017 Latest Legislation: House Bill 49 -...

Section 5167.40 | Appointment of Temporary Manager. - Effective: September 29, 2013 Latest Legislation: House Bill 59 -...

Section 5167.41 | Disenrolling Some or All Medicaid Recipients From Mco Plan Offered by a Managed Care Organization. - Effective: October 17, 2019 Latest Legislation: House Bill 166 -...

Section 5167.45 | Information About Medicaid Recipients' Races, Ethnicities, and Primary Languages. - Effective: April 6, 2017 Latest Legislation: Senate Bill 332 -...

Section 5167.47 | Compliance With Federal Mental Health and Addiction Parity Laws. - Effective: March 24, 2021 Latest Legislation: Senate Bill 284 -...