Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-59 - OhioRISE
Section 5160-59-01.1 - OhioRISE: application of general managed care rules
Universal Citation: OH Admin Code 5160-59-01.1
Current through all regulations passed and filed through September 16, 2024
(A) The Ohio resilience through integrated systems and excellence (OhioRISE) plan has to adhere to all of the requirements applicable to managed care organizations (MCOs) or managed care entities (MCEs) in the following rules:
(1)
Rule
5160-26-05 of the Administrative
Code with the exception of paragraphs (B)(4), (B)(5), (D)(21), (D)(25), and
(D)(26);
(2)
Rule
5160-26-05.1 of the
Administrative Code with the exception of paragraph (B)(1);
(3)
Rule
5160-26-06 of the Administrative
Code;
(4)
Rule
5160-26-08.3 of the
Administrative Code with the exception of paragraphs (A)(19) and
(A)(25);
(5)
Rule
5160-26-08.4 of the
Administrative Code;
(6)
Rule
5160-26-09.1 of the
Administrative Code;
(7)
Rule
5160-26-10 of the Administrative
Code with the exceptions of paragraphs (B)(2)(c), (B)(2)(d), and (B)(2)(e);
and
(8)
Rule
5160-26-11 of the Administrative
Code.
(B) For all rules listed in paragraph (A) of this rule, the following provisions apply to the OhioRISE program described in Chapter 5160-59 of the Administrative Code:
(1)
All references to rule
5160-26-01 of the Administrative
Code are replaced by references to rule
5160-59-01 of the Administrative
Code.
(2)
All references to rules
5160-26-02 and
5160-26-02.1 of the
Administrative Code are replaced by references to rule
5160-59-02 of the Administrative
Code.
(3)
All references to rule
5160-26-03 of the Administrative
Code are replaced by references to rule
5160-59-03 of the Administrative
Code.
(4)
All references to rule
5160-26-03.1 of the
Administrative Code are replaced by references to rule
5160-59-03.1 of the
Administrative Code.
(C) The following rules in Chapter 5160-26 of the Administrative Code do not apply to OhioRISE:
(1)
Rule 5160-26-02 of the Administrative
Code;
(2)
Rule
5160-26-02.1 of the
Administrative Code;
(3)
Rule
5160-26-03 of the Administrative
Code;
(4)
Rule
5160-26-03.1 of the
Administrative Code.
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