Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-26 - Managed Care Plan
- Section 5160-26-01 - Managed: definitions
- Section 5160-26-02 - Managed: eligibility and enrollment
- Section 5160-26-02.1 - Managed care: termination of enrollment
- Section 5160-26-03 - Managed care: covered services
- Section 5160-26-03.1 - Managed care: primary care and utilization management
- Section 5160-26-03.2 - Managed care: long-term services and supports respite services for children
- Section 5160-26-04 - Managed health care programs: procurement and plan selection
- Section 5160-26-05 - Managed care: provider network and contracting requirements
- Section 5160-26-05.1 - Managed care: provider services
- Section 5160-26-06 - Managed care: program integrity - fraud, waste and abuse, audits, reporting, and record retention
- Section 5160-26-07 - Managed health care programs: annual external quality review survey
- Section 5160-26-07.1 - Managed health care programs: Quality assessment and performance improvement program (QAPI)
- Section 5160-26-08 - Managed health care programs: marketing
- Section 5160-26-08.1 - Managed health care programs: information and enrollment services
- Section 5160-26-08.2 - Managed health care programs: member services
- Section 5160-26-08.3 - Managed care: member rights
- Section 5160-26-08.4 - Managed care: appeal and grievance system
- Section 5160-26-08.5 - Managed health care programs: responsibilities for state hearings
- Section 5160-26-09 - Managed health care programs: payment and financial responsibility
- Section 5160-26-09.1 - Managed care: third party liability and recovery
- Section 5160-26-10 - Managed care: sanctions and provider agreement actions
- Section 5160-26-11 - Managed care: non-contracting providers
- Section 5160-26-12 - Managed care: member co-payments
- Section 5160-26-13 - Managed health care programs: claim billing for pharmaceuticals
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