Ohio · Regulations
Chapter 5160-1 — General Provisions
52 sections
52 sections
- Ohio Admin. Code 5160-1-01Rule 5160-1-01. Medicaid medical necessity: definitions and principles
- Ohio Admin. Code 5160-1-02Rule 5160-1-02. General reimbursement principles
- Ohio Admin. Code 5160-1-04Rule 5160-1-04. Employee access to confidential personal information
- Ohio Admin. Code 5160-1-05Rule 5160-1-05. Medicaid coordination of benefits with the medicare program (Title XVIII)
- Ohio Admin. Code 5160-1-05.1Rule 5160-1-05.1. Payment for "Medicare Part C" cost sharing
- Ohio Admin. Code 5160-1-05.3Rule 5160-1-05.3. Payment for "Medicare Part B" cost sharing
- Ohio Admin. Code 5160-1-06.1Rule 5160-1-06.1. Home and community-based service waivers: PASSPORT
- Ohio Admin. Code 5160-1-06.5Rule 5160-1-06.5. Home and community based services (HCBS)
- Ohio Admin. Code 5160-1-08Rule 5160-1-08. Coordination of benefits
- Ohio Admin. Code 5160-1-09Rule 5160-1-09. Co-payments
- Ohio Admin. Code 5160-1-10Rule 5160-1-10. Limitations on elective obstetric deliveries
- Ohio Admin. Code 5160-1-11Rule 5160-1-11. Out-of-state coverage
- Ohio Admin. Code 5160-1-13.1Rule 5160-1-13.1. Medicaid recipient liability
- Ohio Admin. Code 5160-1-14Rule 5160-1-14. Healthchek: early and periodic screening, diagnostic, and treatment (EPSDT) covered services
- Ohio Admin. Code 5160-1-16Rule 5160-1-16. Preventive services
- Ohio Admin. Code 5160-1-17Rule 5160-1-17. Eligible providers
- Ohio Admin. Code 5160-1-17.2Rule 5160-1-17.2. Provider agreement for providers
- Ohio Admin. Code 5160-1-17.3Rule 5160-1-17.3. Provider disclosure requirements
- Ohio Admin. Code 5160-1-17.4Rule 5160-1-17.4. Revalidation of provider agreements
- Ohio Admin. Code 5160-1-17.5Rule 5160-1-17.5. Suspension of medicaid provider agreements
- Ohio Admin. Code 5160-1-17.6Rule 5160-1-17.6. Termination and denial of provider agreement
- Ohio Admin. Code 5160-1-17.7Rule 5160-1-17.7. Application by a former participating medicaid provider to resume participation in the Ohio medicaid program [except for medicaid contracting managed care plans (MCPs)]
- Ohio Admin. Code 5160-1-17.8Rule 5160-1-17.8. Provider screening and application fee
- Ohio Admin. Code 5160-1-17.9Rule 5160-1-17.9. Ordering or referring providers
- Ohio Admin. Code 5160-1-17.12Rule 5160-1-17.12. Qualified entity requirements and responsibilities for determining presumptive eligibility
- Ohio Admin. Code 5160-1-17.51Rule 5160-1-17.51. Suspension of medicaid provider claims payments during a pending audit or investigation
- Ohio Admin. Code 5160-1-18Rule 5160-1-18. Telehealth
- Ohio Admin. Code 5160-1-19Rule 5160-1-19. Submission of medicaid claims
- Ohio Admin. Code 5160-1-20Rule 5160-1-20. Electronic data interchange (EDI) trading partner enrollment and testing
- Ohio Admin. Code 5160-1-25Rule 5160-1-25. Interest on overpayments made to medicaid providers
- Ohio Admin. Code 5160-1-27Rule 5160-1-27. Review of provider records
- Ohio Admin. Code 5160-1-27.1Rule 5160-1-27.1. Hold and review process
- Ohio Admin. Code 5160-1-27.2Rule 5160-1-27.2. Medicaid hold and review process for medicaid claims paid through state agencies other than the Ohio department of medicaid
- Ohio Admin. Code 5160-1-29Rule 5160-1-29. Medicaid fraud, waste, and abuse
- Ohio Admin. Code 5160-1-31Rule 5160-1-31. Prior authorization
- Ohio Admin. Code 5160-1-32Rule 5160-1-32. Medicaid: safeguarding and releasing information
- Ohio Admin. Code 5160-1-32.1Rule 5160-1-32.1. Standard authorization form
- Ohio Admin. Code 5160-1-33Rule 5160-1-33. Medicaid: authorized representatives
- Ohio Admin. Code 5160-1-39Rule 5160-1-39. Verification of home care service provision to home care dependent adults
- Ohio Admin. Code 5160-1-42Rule 5160-1-42. Provider credentialing
- Ohio Admin. Code 5160-1-42.1Rule 5160-1-42.1. Delegated credentialing
- Ohio Admin. Code 5160-1-60Rule 5160-1-60. Medicaid
- Ohio Admin. Code 5160-1-60.2Rule 5160-1-60.2. Direct reimbursement for out-of-pocket expenses incurred for medicaid covered services during approved eligibility periods
- Ohio Admin. Code 5160-1-60.4Rule 5160-1-60.4. By-report procedures, services, and supplies
- Ohio Admin. Code 5160-1-61Rule 5160-1-61. Non-covered services
- Ohio Admin. Code 5160-1-70Rule 5160-1-70. Relocated provisions concerning episode based payments
- Ohio Admin. Code 5160-1-71Rule 5160-1-71. Relocated provisions concerning patient centered medical homes (PCMH) and eligible providers
- Ohio Admin. Code 5160-1-72Rule 5160-1-72. Relocated provisions concerning patient centered medical homes (PCMH) and payments
- Ohio Admin. Code 5160-1-73Rule 5160-1-73. Behavioral health care coordination
- Ohio Admin. Code 5160-1-80Rule 5160-1-80. Substitute practitioners (locum tenens)
- Ohio Admin. Code 5160-1-97Rule 5160-1-97. One-time medicaid provider relief payments
- Ohio Admin. Code 5160-1-98Rule 5160-1-98. Deposits to the health care/medicaid support and recoveries fund for program support