| Ohio Department of Medicaid Resources and Rules (edited 9/20/2016) |
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| A
listing of all proposed rules for the Ohio Department of Medicaid - Register
of Ohio |
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| Medicaid
Forms |
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ODM
QIT Template & QIT Verification Form |
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| Ohio
Medicaid Waiver Comparison Chart - With Enrollment Figures |
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| Medicaid
Eligibility Manual Transmittal Letters (MEMTLs) and Medicaid Eligibility
Procedure Letters (MEPLs) |
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| OAC 5160:1-2-01(F)(5) |
is the Pro Seniors' Rule that Medicaid must
determine eligibility without considering eligibility factors for which
verification cannot be obtained or means of self-support that cannot be
accessed because of the physical or mental impairment. Dubose, et al. v.
ODJFS, et al., S.D.Ohio (W.D.), No.
1:07-CV-945, filed November 2007. |
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| OAC 5160 Medicaid; |
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OAC 5160:1
Medicaid General Principals (Individual regulations listed below) |
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| Rule
Number |
Most Recent Eff. Date |
§1634 Change |
Rule Title |
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| Chapter
5160:1-1 General Medicaid Eligibility Policy |
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| 5160:1-1-01 |
1/1/2016 |
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Medicaid: definitions. |
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| 5160:1-1-03 |
8/1/2016 |
New |
Medicaid: restrictions on
payment for services. |
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| 5160:1-1-04 |
1/10/2015 |
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Medicaid: income and
eligibility verification system (IEVS). |
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| 5160:1-1-50 |
10/1/2013 |
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Medicaid: administrative
code rule migration. |
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| 5160:1-1-51.1 |
10/1/2013 |
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Medicaid: safeguarding and
releasing information. |
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| 5160:1-1-55.1 |
10/1/2013 |
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Medicaid: authorized
representative responsibilities. |
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| 5160:1-1-62 |
4/25/2015 |
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Medicaid: presumptive
eligibility. |
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| Chapter
5160:1-2 Medicaid Application Processing |
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| General
Eligibility |
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| 5160:1-2-01 |
1/1/2016 |
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Medicaid: administrative
agency responsibilities. |
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| 5160:1-2-01.9 |
1/9/2012 |
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Medicaid: income,
exemptions, and disregards. |
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| 5160:1-2-03 |
3/23/2015 |
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Medicaid: application for
home and community-based (HCB) services. |
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| 5160:1-2-04 |
8/1/2016 |
New |
Medicaid: consumer fraud
and erroneous payments. |
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| 5160:1-2-05 (PDF) |
? |
New |
Medicaid: certificate of
creditable coverage and privacy notice. |
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| 5160:1-2-06 |
8/1/2016 |
New |
Medicaid: outstationing
workers at disproportionate share hospitals and federally qualified health
centers. |
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| 5160:1-2-07 |
1/15/2015 |
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Medicaid: Estate Recovery. |
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| 5160:1-2-08 |
8/1/2016 |
New |
Medicaid: individual
responsibilities. |
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| 5160:1-2-10 |
8/1/2016 |
New |
Medicaid: conditions of
eligibility and verification. |
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| 5160:1-2-11 |
8/1/2016 |
New |
Medicaid: United States
(U.S.) citizenship documentation. |
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| 5160:1-2-12 |
8/1/2016 |
New |
Medicaid: non-citizens. |
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| 5160:1-2-14 |
8/1/2016 |
New |
Medicaid: continuous
eligibility for children younger than age nineteen. |
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| 5160:1-2-15 |
9/12/2016 |
New |
Medicaid: Healthchek (Early
and Periodic Screening, Diagnostic and Treatment Services). |
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| 5160:1-2-16 |
1/15/2015 |
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Medicaid: pregnancy related
services (PRS). |
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| Chapter
5160:1-3 Medicaid for the Aged, Blind, or Disabled (ABD) |
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| ABD
Coverage |
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| 5160:1-3-01 |
4/15/2016 |
New |
Medicaid: coverage for the
aged, blind, or disabled. |
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| Base
Eligibility Requirements of the ABD eligibility covered
groups |
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| 5160:1-3-02 |
8/1/2016 |
New |
Medicaid: criteria for age,
blindness, or disability. |
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| 5160:1-3-02.1 |
8/1/2016 |
New |
Medicaid premium assistance
program (MPAP). |
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| 5160:1-3-02.2 |
8/1/2016 |
New |
Medicare buy-in. |
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| 5160:1-3-02.3 |
8/1/2016 |
New |
Medicaid: coverage for
individuals receiving supplemental security income (SSI) benefits. |
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| 5160:1-3-02.4 |
8/1/2016 |
New |
Medicaid: coverage for the
categorically needy. |
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| 5160:1-3-02.5 |
8/1/2016 |
New |
Medicaid: supplemental
security income (SSI) recipients qualifying under section 1619 of the Social
Security Act for continued medical assistance coverage. |
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| 5160:1-3-02.6 |
8/1/2016 |
New |
Medicaid: grandfathering
provisions and deemed eligibility. |
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| 5160:1-3-02.7 |
1/1/2016 |
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Medicaid: continuing care
communities, life care communities and philanthropic long-term care
facilities. |
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| 5160:1-3-02.8 |
12/1/2014 |
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Medicaid: treatment of
qualified long-term care insurance policies. |
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| 5160:1-3-02.9 |
8/1/2016 |
New |
Medicaid: disability
determination process. |
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| Income |
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| 5160:1-3-03.1 |
8/1/2016 |
New |
Medicaid: income. |
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| 5160:1-3-03.2 |
8/1/2016 |
New |
Medicaid: income
exclusions. |
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| 5160:1-3-03.3 |
8/1/2016 |
New |
Medicaid: deeming of
income. |
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| 5160:1-3-03.5 |
8/1/2016 |
New |
Medicaid: application of
income standards. |
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| 5160:1-3-03.6 |
8/1/2016 |
Amendment |
Medicaid: treatment of
rental income. |
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| 5160:1-3-03.7 |
8/1/2016 |
Amendment |
Medicaid: treatment of sick
pay and sick leave. |
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| 5160:1-3-03.8 |
8/1/2016 |
Amendment |
Medicaid: in-kind support
and maintenance. |
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| 5160:1-3-03.10 |
8/1/2016 |
New |
Medicaid: retirement funds. |
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| Patient
Liability & Special Income Level |
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| 5160:1-3-04.1 |
8/1/2016 |
Amendment |
Medicaid: eligibility
through the spenddown process. |
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| 5160:1-3-04.2 |
1/25/2015 |
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Medicaid: income
computations for determining eligibility using the special income level. |
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| 5160:1-3-04.3 |
1/1/2016 |
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Medicaid: determining
patient liability. |
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| 5160:1-3-04.4 |
1/1/2016 |
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Medicaid: income and
patient liability determinations for individuals under the assisted living
home and community based waiver. |
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| Resources |
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| 5160:1-3-05.1 |
8/1/2016 |
New |
Medicaid: resource
requirement. |
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| 5160:1-3-05.2 |
8/1/2016 |
Amendment |
Medicaid: trusts. |
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| 5160:1-3-05.3 |
8/1/2016 |
New |
Medicaid: the disclosure
and treatment of annuities for medical assistance programs. |
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| 5160:1-3-05.4 |
8/1/2016 |
Amendment |
Medicaid: cash and checking
and savings accounts and time deposits. |
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| 5160:1-3-05.5 |
8/1/2016 |
New |
Medicaid: promissory notes,
property agreements, and loans. |
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| 5160:1-3-05.6 |
8/1/2016 |
New |
Medicaid: burial funds and
contracts. |
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| 5160:1-3-05.7 |
8/1/2016 |
New |
Medicaid: burial spaces. |
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| 5160:1-3-05.8 |
8/1/2016 |
Amendment |
Medicaid: lump-sum
payments. |
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| 5160:1-3-05.9 |
8/1/2016 |
New |
Medicaid: dividends and
interest. |
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| 5160:1-3-05.10 |
8/1/2016 |
New |
Medicaid: household goods
and personal effects as resources. |
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| 5160:1-3-05.11 |
8/1/2016 |
Amendment |
Medicaid: automobiles and
other modes of transportation as resources. |
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| 5160:1-3-05.12 |
8/1/2016 |
New |
Medicaid: life insurance. |
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| 5160:1-3-05.13 |
8/1/2016 |
New |
Medicaid: treatment of the
home. |
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| 5160:1-3-05.14 |
8/1/2016 |
New |
Medicaid: resource
exclusion. |
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| 5160:1-3-05.16 |
11/2/2014 |
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Medicaid: home replacement
exclusion. |
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| 5160:1-3-05.17 |
11/2/2014 |
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Medicaid: life estates and
life leases. |
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| 5160:1-3-05.18 |
8/1/2016 |
New |
Medicaid: stocks, mutual
funds, and bonds. |
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| 5160:1-3-05.19 |
8/1/2016 |
Amendment |
Medicaid: real or personal
property essential to self-support. |
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| 5160:1-3-05.20 |
8/1/2016 |
Amendment |
Medicaid: deeming of
resources. |
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| Treatment of
Resources for IS with a CS |
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| 5160:1-3-06.1 |
11/2/2014 |
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Medicaid: treatment of
income and resources of institutionalized individuals. |
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| 5160:1-3-06.2 |
11/2/2014 |
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Medicaid: resource
assessment. |
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| 5160:1-3-06.3 |
11/2/2014 |
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Medicaid: treatment of
resources for institutionalized individuals with a spouse in the community. |
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| 5160:1-3-06.4 |
11/2/2014 |
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Medicaid: resource
budgeting methodology for institutionalized individuals with a spouse in the
community. |
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| 5160:1-3-06.5 |
11/2/2014 |
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Medicaid: transfer of
resources for institutionalized spouses with a spouse in the community. |
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| Transfer of
Resources |
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| 5160:1-3-07.1 |
1/15/2015 |
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Medicaid: social security
administration reporting alleged transfer of resources by supplemental
security income (SSI) applicants to the Ohio department of medicaid (ODM). |
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| 5160:1-3-07.2 |
1/1/2016 |
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Medicaid: transfer of
resources. |
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| 5160:1-3-07.3 |
1/15/2015 |
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Medicaid: disposal of
resources for Ohio department of developmental disabilities and/or Ohio
department of mental health and addiction services individuals. |
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| MAGI-based Medicaid |
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| 5160:1-4-01 |
8/1/2016 |
Amendment |
MAGI-based medicaid: income
and household income. |
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| 5160:1-4-02 |
1/1/2016 |
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MAGI-based medicaid:
coverage for children younger than age nineteen. |
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| 5160:1-4-03 |
1/1/2016 |
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MAGI-based medicaid:
coverage for Ribicoff and former foster care adults. |
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| 5160:1-4-04 |
1/1/2016 |
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MAGI-based medicaid:
coverage for pregnant women. |
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| 5160:1-4-05 |
1/1/2016 |
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MAGI-based medicaid:
coverage for a parent or caretaker relative residing with a child. |
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| Chapter
5160:1-5 Medicaid for Other Covered Groups |
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| Special
Programs |
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| 5160:1-5-01 |
8/1/2016 |
New |
Medicaid: the residential
state supplement (RSS) program. |
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| 5160:1-5-02 |
3/23/2015 |
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Medicaid: breast and
cervical cancer project (BCCP). |
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| 5160:1-5-02.1 |
3/23/2015 |
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Medicaid: breast and cervical cancer project (BCCP)
definitions. |
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| 5160:1-5-02.2 |
3/23/2015 |
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Medicaid: breast and
cervical cancer project (BCCP): eligibility requirements. |
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| 5160:1-5-02.3 |
3/23/2015 |
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Medicaid: breast and
cervical cancer project (BCCP) eligibility period. |
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| 5160:1-5-02.4 |
3/23/2015 |
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Medicaid: breast and
cervical cancer project (BCCP): application and redetermination process. |
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| 5160:1-5-03 |
3/23/2015 |
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Medicaid: medicaid buy-in
for workers with disabilities (MBIWD). |
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| 5160:1-5-05 |
3/23/2015 |
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Medicaid: refugee medical
assistance (RMA). |
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| 5160:1-5-06 |
8/1/2016 |
New |
Medicaid: alien emergency
medical assistance (AEMA). |
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| 5160:1-5-07 |
8/1/2016 |
New |
Medicaid: Specialized
recovery services (SRS) program. |
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| Chapter
5160:1-6 Long-Term Care |
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| QITs |
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| 5160:1-6-03.2 |
5/16/2016 |
New |
Medicaid: use of qualified
income trusts (QIT). |
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