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To amend sections 5162.01, 5162.13, 5162.131, | 1 |
5162.132, 5163.01, 5163.06, 5163.09, 5163.0910, | 2 |
and 5164.911; to amend, for the purpose of | 3 |
adopting a new section number as indicated in | 4 |
parentheses, section 5163.0910 (5162.133); to | 5 |
enact sections 103.41, 103.411, 103.412, 5162.134, | 6 |
5162.70, 5162.71, 5163.04, and 5164.94; and to | 7 |
repeal sections 101.39, 101.391, and 5163.099 of | 8 |
the Revised Code; to amend Section 323.90 of Am. | 9 |
Sub. H.B. 59 of the 130th General Assembly; to | 10 |
require implementation of certain Medicaid | 11 |
revisions, reform systems, and program oversight, | 12 |
and to make an appropriation. | 13 |
Section 1. That sections 5162.01, 5162.13, 5162.131, | 14 |
5162.132, 5163.01, 5163.06, 5163.09, 5163.0910, and 5164.911 be | 15 |
amended; section 5163.0910 (5162.133) be amended for the purpose | 16 |
of adopting a new section number as indicated in parentheses; and | 17 |
sections 103.41, 103.411, 103.412, 5162.134, 5162.70, 5162.71, | 18 |
5163.04, and 5164.94 of the Revised Code be enacted to read as | 19 |
follows: | 20 |
Sec. 103.41. (A) As used in sections 103.41 to 103.412 of | 21 |
the Revised Code: | 22 |
"JMOC" means the joint medicaid oversight committee created | 23 |
under this section. | 24 |
(B) There is hereby created the joint medicaid oversight | 25 |
committee. JMOC shall consist of the following members: | 26 |
(1) Five members of the senate appointed by the president of | 27 |
the senate, three of whom are members of the majority party and | 28 |
two of whom are members of the minority party; | 29 |
(2) Five members of the house of representatives appointed by | 30 |
the speaker of the house of representatives, three of whom are | 31 |
members of the majority party and two of whom are members of the | 32 |
minority party. | 33 |
(C) The term of each JMOC member shall begin on the day of | 34 |
appointment and end on the day that the member's successor on JMOC | 35 |
is appointed. The president and speaker shall make the initial | 36 |
appointments not later than fifteen days after the effective date | 37 |
of this section. The president and speaker shall make subsequent | 38 |
appointments not later than fifteen days after the commencement of | 39 |
the first regular session of each general assembly. JMOC members | 40 |
may be reappointed. A vacancy on JMOC shall be filled in the same | 41 |
manner as the original appointment. | 42 |
(D) In odd-numbered years, the speaker shall designate one of | 43 |
the majority members from the house as the JMOC chairperson and | 44 |
the president shall designate one of the minority members from the | 45 |
senate as the JMOC ranking minority member. In even-numbered | 46 |
years, the president shall designate one of the majority members | 47 |
from the senate as the JMOC chairperson and the speaker shall | 48 |
designate one of the minority members from the house as the JMOC | 49 |
ranking minority member. | 50 |
(E) In appointing members from the minority, and in | 51 |
designating ranking minority members, the president and speaker | 52 |
shall consult with the minority leader of their respective houses. | 53 |
(F) JMOC shall meet at the call of the JMOC chairperson, but | 54 |
not less often than once each calendar month. | 55 |
(G) JMOC shall employ professional, technical, and clerical | 56 |
employees as are necessary for JMOC to be able successfully and | 57 |
efficiently to perform its duties. The employees are in the | 58 |
unclassified service and serve at JMOC's pleasure. JMOC may | 59 |
contract for the services of persons who are qualified by | 60 |
education and experience to advise, consult with, or otherwise | 61 |
assist JMOC in the performance of its duties. | 62 |
(H) The JMOC chairperson, when authorized by JMOC and the | 63 |
president and speaker, may issue subpoenas and subpoenas duces | 64 |
tecum in aid of JMOC's performance of its duties. A subpoena may | 65 |
require a witness in any part of the state to appear before JMOC | 66 |
at a time and place designated in the subpoena to testify. A | 67 |
subpoena duces tecum may require witnesses or other persons in any | 68 |
part of the state to produce books, papers, records, and other | 69 |
tangible evidence before JMOC at a time and place designated in | 70 |
the subpoena duces tecum. A subpoena or subpoena duces tecum shall | 71 |
be issued, served, and returned, and has consequences, as | 72 |
specified in sections 101.41 to 101.45 of the Revised Code. | 73 |
(I) The JMOC chairperson may administer oaths to witnesses | 74 |
appearing before JMOC. | 75 |
Sec. 103.411. (A) JMOC shall oversee the medicaid program on | 76 |
a continuing basis. As part of its oversight, JMOC shall do all of | 77 |
the following: | 78 |
(1) Review how the medicaid program relates to the public and | 79 |
private provision of health care coverage in this state and the | 80 |
United States; | 81 |
(2) Review the reforms implemented under section 5162.70 of | 82 |
the Revised Code and evaluate the reforms' successes in achieving | 83 |
their objectives; | 84 |
(3) Recommend policies and strategies to encourage both of | 85 |
the following: | 86 |
(a) Medicaid recipients becoming self-sufficient; | 87 |
(b) Less use of the medicaid program. | 88 |
(4) Recommend, to the extent JMOC determines appropriate, | 89 |
improvements in statutes and rules concerning the medicaid | 90 |
program; | 91 |
(5) Develop a plan of action for the future of the medicaid | 92 |
program. | 93 |
(B) JMOC may do all of the following: | 94 |
(1) Plan, advertise, organize, and conduct forums, | 95 |
conferences, and other meetings at which representatives of state | 96 |
agencies and other individuals having expertise in the medicaid | 97 |
program may participate to increase knowledge and understanding | 98 |
of, and to develop and propose improvements in, the medicaid | 99 |
program; | 100 |
(2) Prepare and issue reports on the medicaid program; | 101 |
(3) Solicit written comments on, and conduct public hearings | 102 |
at which persons may offer verbal comments on, drafts of its | 103 |
reports. | 104 |
Sec. 103.412. The JMOC chairperson may request that the | 105 |
medicaid director appear before JMOC to provide information and | 106 |
answer questions about the medicaid program. If so requested, the | 107 |
medicaid director shall appear before JMOC at the time and place | 108 |
specified in the request. | 109 |
Sec. 5162.01. (A) As used in the Revised Code: | 110 |
(1) "Medicaid" and "medicaid program" mean the program of | 111 |
medical assistance established by Title XIX of the "Social | 112 |
Security Act," 42 U.S.C. 1396 et seq., including any medical | 113 |
assistance provided under the medicaid state plan or a federal | 114 |
medicaid waiver granted by the United States secretary of health | 115 |
and human services. | 116 |
(2) "Medicare" and "medicare program" mean the federal health | 117 |
insurance program established by Title XVIII of the "Social | 118 |
Security Act," 42 U.S.C. 1395 et seq. | 119 |
(B) As used in this chapter: | 120 |
(1) "Dual eligible individual" has the same meaning as in | 121 |
section 5160.01 of the Revised Code. | 122 |
(2) "Exchange" has the same meaning as in 45 C.F.R. 155.20. | 123 |
(3) "Federal financial participation" has the same meaning as | 124 |
in section 5160.01 of the Revised Code. | 125 |
| 126 |
defined by the United States office of management and budget based | 127 |
on the most recent data available from the United States bureau of | 128 |
the census and revised by the United States secretary of health | 129 |
and human services pursuant to the "Omnibus Budget Reconciliation | 130 |
Act of 1981," section 673(2), 42 U.S.C. 9902(2). | 131 |
| 132 |
medicaid program that covers pregnant women and children and is | 133 |
identified in rules adopted under section 5162.02 of the Revised | 134 |
Code as the healthy start component. | 135 |
| 136 |
of the Revised Code. | 137 |
| 138 |
meaning as in section 5167.01 of the Revised Code. | 139 |
| 140 |
5164.01 of the Revised Code. | 141 |
| 142 |
5164.01 of the Revised Code. | 143 |
| 144 |
5165.01 of the Revised Code. | 145 |
| 146 |
corporation, township, county, school district, or other body | 147 |
corporate and politic responsible for governmental activities only | 148 |
in a geographical area smaller than that of the state. | 149 |
| 150 |
5164.01 of the Revised Code. | 151 |
| 152 |
section 5164.01 of the Revised Code. | 153 |
| 154 |
of education of a city, local, or exempted village school | 155 |
district, the governing authority of a community school | 156 |
established under Chapter 3314. of the Revised Code, the state | 157 |
school for the deaf, and the state school for the blind to which | 158 |
both of the following apply: | 159 |
(a) It holds a valid provider agreement. | 160 |
(b) It meets all other conditions for participation in the | 161 |
medicaid school component of the medicaid program established in | 162 |
rules authorized by section 5162.364 of the Revised Code. | 163 |
| 164 |
or agency, other than the department of medicaid, established by | 165 |
the laws of the state for the exercise of any function of state | 166 |
government. | 167 |
| 168 |
payment to a medicaid provider to correct a previous, incorrect | 169 |
medicaid payment to that provider. | 170 |
Sec. 5162.13. On or before the first day of January of each | 171 |
year, the department of medicaid shall | 172 |
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program in meeting the health care needs of low-income pregnant | 176 |
women, infants, and children. The report shall include: the | 177 |
estimated number of pregnant women, infants, and children eligible | 178 |
for the program; the actual number of eligible persons enrolled in | 179 |
the program; the number of prenatal, postpartum, and child health | 180 |
visits; a report on birth outcomes, including a comparison of | 181 |
low-birthweight births and infant mortality rates of medicaid | 182 |
recipients with the general female child-bearing and infant | 183 |
population in this state; and a comparison of the prenatal, | 184 |
delivery, and child health costs of the program with such costs of | 185 |
similar programs in other states, where available. The department | 186 |
shall submit the report to the general assembly in accordance with | 187 |
section 101.68 of the Revised Code and the joint medicaid | 188 |
oversight committee. The department also shall make the report | 189 |
available to the public. | 190 |
Sec. 5162.131. Semiannually, the medicaid director shall | 191 |
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implementation of programs designed to control the increase of the | 197 |
cost of the medicaid program, increase the efficiency of the | 198 |
medicaid program, and promote better health outcomes. The director | 199 |
shall submit the report to the general assembly in accordance with | 200 |
section 101.68 of the Revised Code and the joint medicaid | 201 |
oversight committee. In each calendar year, one report shall be | 202 |
submitted not later than the last day of June and the subsequent | 203 |
report shall be submitted not later than the last day of December. | 204 |
Sec. 5162.132. Annually, the department of medicaid shall | 205 |
prepare a report on the department's efforts to minimize fraud, | 206 |
waste, and abuse in the medicaid program. | 207 |
Each report shall be made available on the department's web | 208 |
site. The department shall submit a copy of each report to the | 209 |
governor, general assembly, and | 210 |
committee. The copy to the general assembly shall be submitted in | 211 |
accordance with section 101.68 of the Revised Code | 212 |
213 | |
public on request. | 214 |
| 215 |
medicaid director shall submit a report on the medicaid buy-in for | 216 |
workers with disabilities program to the governor, | 217 |
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The copy to the general assembly shall be submitted in accordance | 222 |
with section 101.68 of the Revised Code. The report shall include | 223 |
all of the following information: | 224 |
(A) The number of individuals who participated in the | 225 |
medicaid buy-in for workers with disabilities program; | 226 |
(B) The cost of the program; | 227 |
(C) The amount of revenue generated by premiums that | 228 |
participants pay under section 5163.094 of the Revised Code; | 229 |
(D) The average amount of earned income of participants' | 230 |
families; | 231 |
(E) The average amount of time participants have participated | 232 |
in the program; | 233 |
(F) The types of other health insurance participants have | 234 |
been able to obtain. | 235 |
Sec. 5162.134. Not later than the first day of each July, | 236 |
the medicaid director shall complete a report of the evaluation | 237 |
conducted under section 5164.911 of the Revised Code regarding the | 238 |
integrated care delivery system. The director shall provide a copy | 239 |
of the report to the general assembly and joint medicaid oversight | 240 |
committee. The copy to the general assembly shall be provided in | 241 |
accordance with section 101.68 of the Revised Code. The director | 242 |
also shall make the report available to the public. | 243 |
Sec. 5162.70. (A) As used in this section: | 244 |
(1) "CPI" means the consumer price index for all urban | 245 |
consumers as published by the United States bureau of labor | 246 |
statistics. | 247 |
(2) "Medical inflation rate" means the inflation rate for | 248 |
medical care, or the successor term for medical care, as specified | 249 |
in the CPI. | 250 |
(3) "Successor term" means a term that the United States | 251 |
bureau of labor statistics uses in place of another term in | 252 |
revisions to the CPI. | 253 |
(B) The medicaid director shall implement reforms to the | 254 |
medicaid program that do all of the following: | 255 |
(1) Limit the annual growth in the per recipient per month | 256 |
cost of the medicaid program, as determined on an aggregate basis | 257 |
for all eligibility groups, to not more than the lesser of the | 258 |
following: | 259 |
(a) The average annual increase in the medical inflation rate | 260 |
for the most recent five-year period for which the necessary data | 261 |
is available as of the first day of each calendar year; | 262 |
(b) Three per cent. | 263 |
(2) Achieve the limit in the growth of the per recipient per | 264 |
month cost of the medicaid program under division (B)(1) of this | 265 |
section by doing all of the following: | 266 |
(a) Improving the physical and mental health of medicaid | 267 |
recipients; | 268 |
(b) Providing for medicaid recipients to receive medicaid | 269 |
services in the most cost-effective and sustainable manner; | 270 |
(c) Removing barriers that impede medicaid recipients' | 271 |
ability to transfer to lower cost, and more appropriate, medicaid | 272 |
services, including home and community-based services; | 273 |
(d) Establishing medicaid payment rates that encourage value | 274 |
over volume and result in medicaid services being provided in the | 275 |
most efficient and effective manner possible; | 276 |
(e) Implementing fraud prevention and cost avoidance | 277 |
mechanisms to the fullest extent possible; | 278 |
(f) Integrating the delivery of physical and behavioral | 279 |
health services covered by medicaid to the fullest extent | 280 |
possible. | 281 |
(3) Reduce the prevalence of comorbid health conditions | 282 |
among, and the mortality rates of, medicaid recipients. | 283 |
(C) The medicaid director shall implement the reforms under | 284 |
this section in accordance with evidence-based strategies that | 285 |
include measurable goals. | 286 |
(D) The reforms implemented under this section shall, without | 287 |
making the medicaid program's eligibility requirements more | 288 |
restrictive, reduce the relative number of individuals enrolled in | 289 |
the medicaid program who have the greatest potential to obtain the | 290 |
income and resources that would enable them to cease enrollment in | 291 |
medicaid and instead obtain health care coverage through | 292 |
employer-sponsored health insurance or an exchange. | 293 |
Sec. 5162.71. The medicaid director shall implement within | 294 |
the medicaid program systems that do both of the following: | 295 |
(A) Improve the health of medicaid recipients through the use | 296 |
of population health measures; | 297 |
(B) Reduce health disparities. | 298 |
Sec. 5163.01. As used in this chapter: | 299 |
"Caretaker relative" has the same meaning as in 42 C.F.R. | 300 |
435.4 as that regulation is amended effective January 1, 2014. | 301 |
"Children's hospital" has the same meaning as in section | 302 |
2151.86 of the Revised Code. | 303 |
"Federal financial participation" has the same meaning as in | 304 |
section 5160.01 of the Revised Code. | 305 |
"Federally qualified health center" has the same meaning as | 306 |
in the "Social Security Act," section 1905(l)(2)(B), 42 U.S.C. | 307 |
1396d(l)(2)(B). | 308 |
"Federally qualified health center look-alike" has the same | 309 |
meaning as in section 3701.047 of the Revised Code. | 310 |
"Federal poverty line" has the same meaning as in section | 311 |
5162.01 of the Revised Code. | 312 |
"Healthy start component" has the same meaning as in section | 313 |
5162.01 of the Revised Code. | 314 |
"Home and community-based services medicaid waiver component" | 315 |
has the same meaning as in section 5166.01 of the Revised Code. | 316 |
"Intermediate care facility for individuals with intellectual | 317 |
disabilities" and "ICF/IID" have the same meanings as in section | 318 |
5124.01 of the Revised Code. | 319 |
"Mandatory eligibility groups" means the groups of | 320 |
individuals that must be covered by the medicaid state plan as a | 321 |
condition of the state receiving federal financial participation | 322 |
for the medicaid program. | 323 |
"Medicaid buy-in for workers with disabilities program" means | 324 |
the component of the medicaid program established under sections | 325 |
5163.09 to | 326 |
"Medicaid services" has the same meaning as in section | 327 |
5164.01 of the Revised Code. | 328 |
"Medicaid waiver component" has the same meaning as in | 329 |
section 5166.01 of the Revised Code. | 330 |
"Nursing facility" and "nursing facility services" have the | 331 |
same meanings as in section 5165.01 of the Revised Code. | 332 |
"Optional eligibility groups" means the groups of individuals | 333 |
who may be covered by the medicaid state plan or a federal | 334 |
medicaid waiver and for whom the medicaid program receives federal | 335 |
financial participation. | 336 |
"Other medicaid-funded long-term care services" has the | 337 |
meaning specified in rules adopted under section 5163.02 of the | 338 |
Revised Code. | 339 |
"Supplemental security income program" means the program | 340 |
established by Title XVI of the "Social Security Act," 42 U.S.C. | 341 |
1381 et seq. | 342 |
Sec. 5163.04. The medicaid program shall not cover the group | 343 |
described in the "Social Security Act," section | 344 |
1902(a)(10)(A)(i)(VIII), 42 U.S.C. 1396a(a)(10)(A)(i)(VIII), | 345 |
unless the federal medical assistance percentage for expenditures | 346 |
for medicaid services provided to the group is at least the amount | 347 |
specified in the "Social Security Act," section 1905(y), 42 U.S.C. | 348 |
1396d(y), as of March 30, 2010. If the medicaid program covers the | 349 |
group and the federal medical assistance percentage for such | 350 |
expenditures is reduced below the amount so specified, the | 351 |
medicaid program shall cease to cover the group. Notwithstanding | 352 |
section 5160.31 of the Revised Code, an individual's disenrollment | 353 |
from the medicaid program is not subject to appeal under that | 354 |
section when the disenrollment is the result of the medicaid | 355 |
program ceasing to cover the individual's group under this | 356 |
section. | 357 |
Sec. 5163.06. The medicaid program shall cover all of the | 358 |
following optional eligibility groups: | 359 |
(A) The group consisting of children placed with adoptive | 360 |
parents who are specified in the "Social Security Act," section | 361 |
1902(a)(10)(A)(ii)(VIII), 42 U.S.C. 1396a(a)(10)(A)(ii)(VIII); | 362 |
(B) Subject to section 5163.061 of the Revised Code, the | 363 |
group consisting of women during pregnancy and the sixty-day | 364 |
period beginning on the last day of the pregnancy, infants, and | 365 |
children who are specified in the "Social Security Act," section | 366 |
1902(a)(10)(A)(ii)(IX), 42 U.S.C. 1396a(a)(10)(A)(ii)(IX); | 367 |
(C) Subject to sections 5163.09 to | 368 |
Revised Code, the group consisting of employed individuals with | 369 |
disabilities who are specified in the "Social Security Act," | 370 |
section 1902(a)(10)(A)(ii)(XV), 42 U.S.C. 1396a(a)(10)(A)(ii)(XV); | 371 |
(D) Subject to sections 5163.09 to | 372 |
Revised Code, the group consisting of employed individuals with | 373 |
medically improved disabilities who are specified in the "Social | 374 |
Security Act," section 1902(a)(10)(A)(ii)(XVI), 42 U.S.C. | 375 |
1396a(a)(10)(A)(ii)(XVI); | 376 |
(E) The group consisting of independent foster care | 377 |
adolescents who are specified in the "Social Security Act," | 378 |
section 1902(a)(10)(A)(ii)(XVII), 42 U.S.C. | 379 |
1396a(a)(10)(A)(ii)(XVII); | 380 |
(F) The group consisting of women in need of treatment for | 381 |
breast or cervical cancer who are specified in the "Social | 382 |
Security Act," section 1902(a)(10)(A)(ii)(XVIII), 42 U.S.C. | 383 |
1396a(a)(10)(A)(ii)(XVIII); | 384 |
(G) The group consisting of nonpregnant individuals who may | 385 |
receive family planning services and supplies and are specified in | 386 |
the "Social Security Act," section 1902(a)(10)(A)(ii)(XXI), 42 | 387 |
U.S.C. 1396a(a)(10)(A)(ii)(XXI). | 388 |
Sec. 5163.09. (A) As used in sections 5163.09 to | 389 |
5163.098 of the Revised Code: | 390 |
"Applicant" means an individual who applies to participate in | 391 |
the medicaid buy-in for workers with disabilities program. | 392 |
"Earned income" has the meaning established by rules | 393 |
authorized by section 5163.098 of the Revised Code. | 394 |
"Employed individual with a medically improved disability" | 395 |
has the same meaning as in the "Social Security Act," section | 396 |
1905(v), 42 U.S.C. 1396d(v). | 397 |
"Family" means an applicant or participant and the spouse and | 398 |
dependent children of the applicant or participant. If an | 399 |
applicant or participant is under eighteen years of age, "family" | 400 |
also means the parents of the applicant or participant. | 401 |
"Health insurance" has the meaning established by rules | 402 |
authorized by section 5163.098 of the Revised Code. | 403 |
"Income" means earned income and unearned income. | 404 |
"Participant" means an individual who has been determined | 405 |
eligible for the medicaid buy-in for workers with disabilities | 406 |
program and is participating in the program. | 407 |
"Resources" has the meaning established by rules authorized | 408 |
by section 5163.098 of the Revised Code. | 409 |
"Spouse" has the meaning established in rules authorized by | 410 |
section 5163.098 of the Revised Code. | 411 |
"Unearned income" has the meaning established by rules | 412 |
authorized by section 5163.098 of the Revised Code. | 413 |
(B) The medicaid program's coverage of the optional | 414 |
eligibility groups specified in the "Social Security Act," section | 415 |
1902(a)(10)(A)(ii)(XV) and (XVI), 42 U.S.C. | 416 |
1396a(a)(10)(A)(ii)(XV) and (XVI) shall be known as the medicaid | 417 |
buy-in for workers with disabilities program. | 418 |
Sec. 5164.911. (A) If the medicaid director implements the | 419 |
integrated care delivery system and except as provided in division | 420 |
421 | |
of the following: | 422 |
(1) The health outcomes of ICDS participants; | 423 |
(2) How changes to the administration of the ICDS affect all | 424 |
of the following: | 425 |
(a) Claims processing; | 426 |
(b) The appeals process; | 427 |
(c) The number of reassessments requested; | 428 |
(d) Prior authorization requests for services. | 429 |
(3) The provider panel selection process used by medicaid | 430 |
managed care organizations participating in the ICDS. | 431 |
(B) When conducting an evaluation under division (A) of this | 432 |
section, the director shall do all of the following: | 433 |
(1) For the purpose of division (A)(1) of this section, do | 434 |
both of the following: | 435 |
(a) Compare the health outcomes of ICDS participants to the | 436 |
health outcomes of individuals who are not ICDS participants; | 437 |
(b) Use both of the following: | 438 |
(i) A control group consisting of ICDS participants who | 439 |
receive health care services from providers not participating in | 440 |
ICDS; | 441 |
(ii) A control group consisting of ICDS participants who | 442 |
receive health care services from alternative providers that are | 443 |
not part of a participating medicaid managed care organization's | 444 |
provider panel but provide health care services in the geographic | 445 |
service area in which ICDS participants receive health care | 446 |
services. | 447 |
(2) For the purpose of division (A)(2) of this section, do | 448 |
all of the following: | 449 |
(a) To the extent the data is available, use data from all of | 450 |
the following: | 451 |
(i) The fee-for-service component of the medicaid program; | 452 |
(ii) Medicaid managed care organizations; | 453 |
(iii) Managed care organizations participating in the | 454 |
medicare advantage program established under Part C of Title XVIII | 455 |
of the "Social Security Act," 42 U.S.C. 1395w-21 et seq. | 456 |
(b) Identify all of the following: | 457 |
(i) Changes in the amount of time it takes to process claims | 458 |
and the number of claims denied and the reasons for the changes; | 459 |
(ii) The impact that changes to the administration of the | 460 |
ICDS had on the appeals process and number of reassessments | 461 |
requested; | 462 |
(iii) The number of prior authorization denials that were | 463 |
overturned and the reasons for the overturned denials. | 464 |
(3) Require medicaid managed care organizations participating | 465 |
in the ICDS to submit to the director any data the director needs | 466 |
for the evaluation. | 467 |
(C) | 468 |
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| 473 |
under this section for a year if the same evaluation is conducted | 474 |
for that year by an organization under contract with the United | 475 |
States department of health and human services. | 476 |
Sec. 5164.94. The medicaid director shall implement within | 477 |
the medicaid program a system that encourages medicaid providers | 478 |
to provide medicaid services to medicaid recipients in culturally | 479 |
and linguistically appropriate manners. | 480 |
Section 2. That existing sections 5162.01, 5162.13, | 481 |
5162.131, 5162.132, 5163.01, 5163.06, 5163.09, 5163.0910, and | 482 |
5164.911 of the Revised Code are hereby repealed. | 483 |
Section 3. That sections 101.39, 101.391, and 5163.099 of the | 484 |
Revised Code are hereby repealed. | 485 |
Section 4. That Section 323.90 of Am. Sub. H.B. 59 of the | 486 |
130th General Assembly be amended to read as follows: | 487 |
Sec. 323.90. JOINT | 488 |
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(A) | 490 |
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following issues: | 515 |
(1) The implementation of the dual eligible integrated care | 516 |
demonstration project authorized by section 5164.91 of the Revised | 517 |
Code; | 518 |
(2) The implementation of a unified long-term services and | 519 |
support Medicaid waiver component under section 5166.14 of the | 520 |
Revised Code; | 521 |
(3) Providing consumers choices regarding a continuum of | 522 |
services that meet their health-care needs, promote autonomy and | 523 |
independence, and improve quality of life; | 524 |
(4) Ensuring that long-term care services and supports are | 525 |
delivered in a cost-effective and quality manner; | 526 |
(5) Subjecting county homes, county nursing homes, and | 527 |
district homes operated pursuant to Chapter 5155. of the Revised | 528 |
Code to the franchise permit fee under sections 5168.40 to 5168.56 | 529 |
of the Revised Code; | 530 |
(6) Other issues of interest to the committee. | 531 |
| 532 |
provide for the Medicaid Director to testify before the Committee | 533 |
at least quarterly regarding the issues that the Committee | 534 |
examines. | 535 |
Section 5. That existing Section 323.90 of Am. Sub. H.B. 59 | 536 |
of the 130th General Assembly is hereby repealed. | 537 |
Section 6. The Joint Medicaid Oversight Committee shall | 538 |
prepare a report with recommendations for legislation regarding | 539 |
Medicaid payment rates for Medicaid services. The goal of the | 540 |
recommendations shall be to provide the Medicaid Director | 541 |
statutory authority to implement innovative methodologies for | 542 |
setting Medicaid payment rates that limit the growth in Medicaid | 543 |
costs and protect, and establish guiding principles for, Medicaid | 544 |
providers and recipients. The Medicaid Director shall assist the | 545 |
Committee with the report. The Committee shall submit the report | 546 |
to the General Assembly in accordance with section 101.68 of the | 547 |
Revised Code not later than January 1, 2014. | 548 |
Section 7. All items in this section are hereby appropriated | 549 |
as designated out of any moneys in the state treasury to the | 550 |
credit of the designated fund. For all appropriations made in this | 551 |
act, those in the first column are for fiscal year 2014 and those | 552 |
in the second column are for fiscal year 2015. The appropriations | 553 |
made in this act are in addition to any other appropriations made | 554 |
for the FY 2014-FY 2015 biennium. | 555 |
Appropriations |
556 | |
General Revenue Fund | 557 |
GRF | 048321 | Operating Expenses | $ | 350,000 | $ | 500,000 | 558 | ||||
TOTAL GRF General Revenue Fund | $ | 350,000 | $ | 500,000 | 559 | ||||||
TOTAL ALL BUDGET FUND GROUPS | $ | 350,000 | $ | 500,000 | 560 |
OPERATING EXPENSES | 561 |
The foregoing appropriation item 048321, Operating Expenses, | 562 |
shall be used to support expenses related to the Joint Medicaid | 563 |
Oversight Committee created by section 103.41 of the Revised Code. | 564 |
Section 8. Within the limits set forth in this act, the | 565 |
Director of Budget and Management shall establish accounts | 566 |
indicating the source and amount of funds for each appropriation | 567 |
made in this act, and shall determine the form and manner in which | 568 |
appropriation accounts shall be maintained. Expenditures from | 569 |
appropriations contained in this act shall be accounted for as | 570 |
though made in the main operating appropriations act of the 130th | 571 |
General Assembly. | 572 |
The appropriations made in this act are subject to all | 573 |
provisions of the main operating appropriations act of the 130th | 574 |
General Assembly that are generally applicable to such | 575 |
appropriations. | 576 |