RESPONSIBILITIES OF ODM. ODM, pursuant to federal regulation, is responsible for the administration of the Medicaid program and the collection of Medicaid data in the State of Ohio. ODM shall retain final authority for the administrative decisions related to Medicaid Information Technology System (MITS) data. ODM shall cooperate with ODH to plan, implement, monitor, and evaluate the provision of services under this Attachment D.
1. ODM will provide electronic claim line data to ODH in an electronic format at intervals agreeable to ODM and ODH to update data in Impact/SIIS.
2. ODM will provide points of contact to ODH for notification activities included in ARTICLE III.
RESPONSIBILITIES OF ODM. A. ODM will act as the single state agency for Ohio's Medicaid Program as defined in 42 CFR 431.10.
B. ODM will file Medicaid State Plan amendments related to administrative activities performed by ODH and/or LPHDs with the Centers for Medicare and Medicaid(CMS).
RESPONSIBILITIES OF ODM. X. XXX agrees to:
1. Require County Departments of Job and Family Services (CDJFS) staff to identify participants potentially eligible for the Maternal and Child Health programs and to refer them to the appropriate program.
2. Provide ODH Helpline employees with information necessary to maintain accurate information about ODM, when necessary.
3. Keep an up-to-date listing of the names and addresses of CDJFS Healthchek and PRS Coordinators on the ODM website.
RESPONSIBILITIES OF ODM. ODM will:
1. Pay the federal and nonfederal shares of Ohio Tobacco Quit Line services provided to Medicaid recipients incurred by ODH.
2. Take steps to make Medicaid providers aware of the Ohio Tobacco Quit Line services that are available to Medicaid recipients.
3. Review and approve ODH claims subject to compliance with applicable federal and state requirements. ODM shall approve and remit payment to ODH within 30 days of the approved invoice date.
RESPONSIBILITIES OF ODM. Provide cost reporting forms to participating hospitals.
RESPONSIBILITIES OF ODM. X. XXX agrees to:
1. Require County Departments of Job and Family Services (CDJFS) staff to identify participants potentially eligible for the WIC and Maternal and Child Health programs and to refer them to the appropriate program. Attention shall be given to the timely referral of children with or at risk for developmental delays or disabilities in order to promote their access to primary and preventive health care.
2. Make available to ODH's Office of Health Improvement and Wellness (OHIW) and HIV Care Services Program staff the appropriate online application/recipient eligibility subsystem.
3. Provide technical assistance to XXX’s OHIW for Medicaid eligibility and the Healthchek and Pregnancy Related Services (PRS) , as requested, particularly when changes are proposed or occur, or when relevant audit findings reveal interpretation or practice conflicts.
4. Provide ODH with information necessary to maintain accurate information about ODM programs for use by ODH Helpline employees.
5. Keep an up-to-date listing of the names and addresses of CDJFS Healthchek and PRS Coordinators on the ODM website.
6. Initiate, as appropriate, information sharing sessions that will inform XXX on proposed federal and state regulations, policy, forms and OAC rule changes, such as changes related to the Application for Health Coverage & Help Paying Costs ODM07216, Healthchek and PRS. ODM will participate in the information sessions facilitated by ODH.
7. Allow ODM contracted Managed Care providers to verify recipient’s current Medicaid status through their connection to the Medicaid Information Technology System (MITS) for assisting with determining WIC and Maternal and Child Health Program eligibility.
B. In accordance with CFDA requirements, ODM will monitor the activities of ODH to ensure its compliance with program and administrative requirements. In this role, ODM may:
1. Perform fiscal or compliance reviews to determine accuracy and appropriateness of Intrastate Transfer Vouchers (ISTVs), making adjustments to ISTVs in accordance with any resulting review findings.
2. Notify ODH staff in writing of the results of any programmatic, fiscal and/or compliance reviews.
3. Request a Corrective Action Plan (CAP) for monitoring review findings and determine if ODH takes appropriate and timely corrective action.
4. Consider whether XXX’s CAP meets the requirements necessary to correct finding(s).
RESPONSIBILITIES OF ODM. A. ODM is designated as the single state agency for the administration of the Medicaid program under Title XIX of the Social Security Act.
B. In accordance with federal and state regulations governing Ohio's early and periodic screening, diagnostic and treatment (EPSDT) program, hereinafter referred to as Healthchek services for promotional purposes (Title 42, Parts 400 and 441 of the Code of Federal Regulations (CFR), and Section 5164.26 of the Ohio Revised Code (ORC) mandating the application of preventive measures for the reduction of disease in children) ODM shall perform the following functions:
1. Inform all Healthchek providers (to include all managed care providers (MCPs)) who use private clinical laboratories, of their responsibilities to report the items mandated by rule 3701-30-05(A) through (E) of the Ohio Administrative Code (OAC) to an approved clinical laboratory.
2. Maintain communication with and provide training to, at least on an annual basis, the eighty-eight
RESPONSIBILITIES OF ODM. ODM will:
1. Pay the federal and nonfederal shares of Ohio Tobacco Quit Line services provided to Medicaid recipients incurred by ODH.
2. Take steps to make Medicaid providers aware of the Ohio Tobacco Quit Line services that are available to Medicaid recipients.
3. Review and approve ODH claims subject to compliance with applicable federal and state requirements. ODM shall approve and remit payment to ODH within 30 days of the approved invoice date.
4. Provide appropriate claim format to ODH to facilitate submission of claims by ODM to the Centers for Medicare and Medicaid Services (CMS) to facilitate reimbursement of the federal shares to ODM.
5. Ensure all claims for reimbursement meet requirements to assist ODM to administer the Medicaid program.
6. If CMS, ODM, ODH, or other authority, through any means, determines a previously submitted claim resulted in an overpayment of Federal Financial Participation (FFP), ODM will provide notice to ODH and initiate an intra state transfer voucher (ISTV) to collect the unallowable federal and non-federal amount within 60 days of notification.
7. Work with ODH to prepare a plan to reduce tobacco use by Ohioans, with emphasis on reducing the use of tobacco by youth, minority and regional populations, pregnant women, Medicaid recipients, and others who may be disproportionately affected by the use of tobacco as included in Ohio Revised Code 3701.84. Ohio Department of Health – Attachment E A-1819-04-0113E Page 2 of 2
RESPONSIBILITIES OF ODM. ODM will:
RESPONSIBILITIES OF ODM
