Current as of January 01, 2020 | Updated by FindLaw Staff
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(A) As used in this section, “medicaid maximum allowable amount” means one hundred per cent of a nursing facility's total per medicaid day payment rate.
(B) Instead of paying the total per medicaid day payment rate determined under section 5165.15 of the Revised Code, the department of medicaid shall pay the provider of a nursing facility the lesser of the following for nursing facility services the nursing facility provides on or after January 1, 2012, to a dual eligible individual who is eligible for nursing facility services under the medicaid program and post-hospital extended care services under Part A of Title XVIII:
(1) The coinsurance amount for the services as provided under Part A of Title XVIII;
(2) The medicaid maximum allowable amount for the services, less the amount paid under Part A of Title XVIII for the services.
Cite this article: FindLaw.com - Ohio Revised Code Title LI. Public Welfare § 5165.155 - last updated January 01, 2020 | https://codes.findlaw.com/oh/title-li-public-welfare/oh-rev-code-sect-5165-155/
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