Each medicaid managed care organization shall implement a coordinated services program for the organization’s enrollees who are found to have obtained prescribed drugs under the medicaid program at a frequency or in an amount that is not medically necessary. The program shall be implemented in a manner that is consistent with section 1915(a)(2) of the “Social Security Act,” 42 U.S.C. § 1396n(a)(2), and 42 C.F.R. § 431.54(e).

Terms Used In Ohio Code 5167.13

  • Medicaid managed care organization: means a managed care organization under contract with the department of medicaid pursuant to section 5167. See Ohio Code 5167.01