(A) For the purpose of raising funds necessary to pay the expenses of implementing the provider screening requirements of subpart E of 42 C.F.R. part 455 and except as provided in division (B) of this section, the department of medicaid shall collect an application fee from a medicaid provider before doing any of the following:

Terms Used In Ohio Code 5164.31

  • medicaid provider: includes a person or government entity applying for a provider agreement, a former medicaid provider, or both. See Ohio Code 5164.01
  • Provider agreement: means an agreement to which all of the following apply:

    (1) It is between a medicaid provider and the department of medicaid;

    (2) It provides for the medicaid provider to provide medicaid services to medicaid recipients;

    (3) It complies with 42 C. See Ohio Code 5164.01

  • Rule: includes regulation. See Ohio Code 1.59

(1) Entering into a provider agreement with a medicaid provider that seeks initial enrollment as a provider;

(2) Entering into a provider agreement with a former medicaid provider that seeks re-enrollment as a provider;

(3) Revalidating a medicaid provider’s continued enrollment as a provider.

(B) The department is not to collect an application fee from a medicaid provider that is exempt from paying the fee under 42 C.F.R. § 455.460(a).

(C) The application fees shall be deposited into the health care/medicaid support and recoveries fund created under section 5162.52 of the Revised Code. Application fees are nonrefundable when collected in accordance with 42 C.F.R. § 455.460(a).

(D) The medicaid director shall adopt rules under section 5164.02 of the Revised Code as necessary to implement this section, including a rule establishing the amount of the application fee to be collected under this section. The amount of the application fee shall not be set at an amount that is more than necessary to pay for the expenses of implementing the provider screening requirements.

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