Ohio Revised Code Title LI. Public Welfare § 5167.21

(1) “Covered skilled nursing facility services” has the same meaning as in the “Social Security Act,” section 1888(e)(2)(A), 42 U.S.C. 1395yy(e)(2)(A).

(2) “Current medicare fee-for-service rate” means the fee-for-service rate in effect for a covered skilled nursing facility service under medicare at the time the service is provided.

(3) “Skilled nursing facility” has the same meaning as in the “Social Security Act,” section 1819(a), 42 U.S.C. 1395i-3(a).

(1) The United States secretary agrees to the payment rate as part of the contract that the medicaid managed care organization, medicaid director, and United States secretary jointly enter into under the integrated care delivery system;

(2) The medicaid managed care organization receives a federal capitation payment that is an actuarially sufficient amount for the costs that the medicaid managed care organization incurs in paying the rate;

(3) No state funds are used for any part of the costs that the medicaid managed care organization incurs in paying the rate;

(4) The integrated care delivery system provides for dual eligible individuals to receive the covered skilled nursing facility services as part of the system.