5111.0211 [Effective 9/13/2010] Nursing facility not required to submit Medicaid claim for Medicare cost-sharing expenses under certain circumstances.
5111.0211 [Effective 9/13/2010] Nursing facility not required to submit Medicaid claim for Medicare cost-sharing expenses under certain circumstances.
As used in this section, “nursing facility” and “provider” have the same meanings as in section 5111.20 of the Revised Code.
The provider of a nursing facility is not required to submit a claim to the department of job and family services regarding the medicare cost-sharing expenses of a resident of the nursing facility who, under federal law, is eligible to have the medicaid program pay for a part of the cost-sharing expenses if the provider determines that, under rules adopted under section 5111.02 of the Revised Code, the nursing facility would not receive a medicaid payment for any part of the medicare cost-sharing expenses. In such a situation, a claim for the medicare cost-sharing expenses shall be considered to have been adjudicated at no payment.
Added by 128th General Assembly File No. 44, HB 215, § 1, eff. 9/13/2010.