Ohio § 5165.40 Adjustment of rates

Ohio Statutes

§ 5165.40 — Adjustment of rates

Ohio § 5165.40

Title 51Public Welfare

Ch. 5165Medicaid Coverage of Nursing Facility Services

This text of Ohio § 5165.40 (Adjustment of rates) 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. § 5165.40 (2026).

Text

If a nursing facility provider properly amends  a cost report for the nursing facility under section5165.107of  the Revised Code and the amended report shows that the provider  received a lower medicaid payment rate under the original cost  report than the provider was entitled to receive, the department  of medicaid shall adjust the provider's rate for the nursing  facility prospectively to reflect the corrected information. The  department shall pay the adjusted rate beginning two months after  the first day of the month after the provider files the amended  cost report.

If the department finds, from an exception review of resident  assessment data conducted pursuant to section5165.193of the  Revised Code after the effective date of a nursing facility's rate  for direct care costs that 

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If a nursing facility provider properly amends a cost report for the nursing facility under section5165.107of the Revised Code and the amended report shows that the provider received a lower medicaid payment rate under the original cost report than the provider was entitled to receive, the department of medicaid shall adjust the provider's rate for the nursing facility prospectively to reflect the corrected information. The department shall pay the adjusted rate beginning two months after the first day of the month after the provider files the amended cost report.

If the department finds, from an exception review of resident assessment data conducted pursuant to section5165.193of the Revised Code after the effective date of a nursing facility's rate for direct care costs that is based on the resident assessment data, that inaccurate resident assessment data resulted in the provider receiving a lower rate for the nursing facility than it was entitled to receive, the department prospectively shall adjust the provider's rate accordingly. The department shall make payments to the provider using the adjusted rate for the remainder of the six-month period for which the resident assessment data is used to determine the rate, beginning one month after the first day of the month after the exception review is completed.