Ohio § 5165.155 Amount of payments for dual eligible individuals

Ohio Statutes

§ 5165.155 — Amount of payments for dual eligible individuals

Ohio § 5165.155

Title 51Public Welfare

Ch. 5165Medicaid Coverage of Nursing Facility Services

This text of Ohio § 5165.155 (Amount of payments for dual eligible individuals) is published on Counsel Stack Legal Research, covering Ohio primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ohio Rev. Code Ann. § 5165.155 (2026).

Text

(A)As used in this section, "medicaid maximum allowable amount" means one hundred per cent of a nursing facility's total per medicaid day payment rate.

(B)Instead of paying the total per medicaid day payment rate determined under section5165.15of the Revised Code, the department of medicaid shall pay the provider of a nursing facility the lesser of the following for nursing facility services the nursing facility provides on or after January 1, 2012, to a dual eligible individual who is eligible for nursing facility services under the medicaid program and post-hospital extended care services under Part A of Title XVIII:

(1)The coinsurance amount for the services as provided under Part A of Title XVIII;

(2)The medicaid maximum allowable amount for the services, less the amo

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(A) As used in this section, "medicaid maximum allowable amount" means one hundred per cent of a nursing facility's total per medicaid day payment rate.

(B) Instead of paying the total per medicaid day payment rate determined under section5165.15of the Revised Code, the department of medicaid shall pay the provider of a nursing facility the lesser of the following for nursing facility services the nursing facility provides on or after January 1, 2012, to a dual eligible individual who is eligible for nursing facility services under the medicaid program and post-hospital extended care services under Part A of Title XVIII:

(1) The coinsurance amount for the services as provided under Part A of Title XVIII;

(2) The medicaid maximum allowable amount for the services, less the amount paid under Part A of Title XVIII for the services.