Ohio Department of Medicaid Resources and Rules (edited 9/20/2016)
A listing of all proposed rules for the Ohio Department of Medicaid - Register of Ohio
Medicaid Forms			ODM QIT Template & QIT Verification Form
Ohio Medicaid Waiver Comparison Chart - With Enrollment Figures
Medicaid Eligibility Manual Transmittal Letters (MEMTLs) and Medicaid Eligibility Procedure Letters (MEPLs)
OAC 5160:1-2-01(F)(5)	is the Pro Seniors' Rule that Medicaid must determine eligibility without considering eligibility factors for which verification cannot be obtained or means of self-support that cannot be accessed because of the physical or mental impairment.   Dubose, et al. v. ODJFS, et al., S.D.Ohio (W.D.), No. 1:07-CV-945, filed November 2007.
OAC 5160 Medicaid;			OAC 5160:1 Medicaid General Principals (Individual regulations listed below)
Rule Number	Most Recent Eff. Date	§1634 Change	Rule Title
Chapter 5160:1-1 General Medicaid Eligibility Policy
5160:1-1-01	9/1/2017		Medicaid: definitions.
5160:1-1-03	1/1/2017	New	Medicaid: restrictions on payment for services.
5160:1-1-04	1/10/2015		Medicaid: income and eligibility verification system (IEVS).
5160:1-1-50	1/1/2017	Rescinded	Medicaid: administrative code rule migration.
5160:1-1-51.1	1/1/2017	Rescinded	Medicaid: safeguarding and releasing information.
5160:1-1-55.1	1/1/2017	Rescinded	Medicaid: authorized representative responsibilities.
5160:1-1-62	1/1/2017	Rescinded	Medicaid: presumptive eligibility.
Chapter 5160:1-2 Medicaid Application Processing
General Eligibility
5160:1-2-01	1/1/2017		Medicaid: administrative agency responsibilities.
5160:1-2-01.9	1/9/2012		Medicaid: income, exemptions, and disregards.
5160:1-2-03	3/23/2015		Medicaid: application for home and community-based (HCB) services.
5160:1-2-04	8/1/2016	New	Medicaid: consumer fraud and erroneous payments.
5160:1-2-05	1/1/2017	New	Medicaid: certificate of creditable coverage and privacy notice.
5160:1-2-06	8/1/2016	New	Medicaid: outstationing workers at disproportionate share hospitals and federally qualified health centers.
5160:1-2-07	1/15/2015		Medicaid: Estate Recovery.
5160:1-2-08	8/1/2017	New	Medicaid: individual responsibilities.
5160:1-2-10	1/1/2017	New	Medicaid: conditions of eligibility and verification.
5160:1-2-11	8/1/2016	New	Medicaid: United States (U.S.) citizenship documentation.
5160:1-2-12	8/1/2016	New	Medicaid: non-citizens.
5160:1-2-13	1/1/2017	New	Medicaid: presumptive eligibility
5160:1-2-14	8/1/2016	New	Medicaid: continuous eligibility for children younger than age nineteen.
5160:1-2-15	9/12/2016	New	Medicaid: Healthchek (Early and Periodic Screening, Diagnostic and Treatment Services).
5160:1-2-16	1/15/2015		Medicaid: pregnancy related services (PRS).
Chapter 5160:1-3 Medicaid for the Aged, Blind, or Disabled (ABD)
ABD Coverage
5160:1-3-01	8/1/2016	New	Medicaid: coverage for the aged, blind, or disabled.
Base Eligibility Requirements of the ABD eligibility covered groups
5160:1-3-02	9/1/2017	New	Medicaid: criteria for age, blindness, or disability.
5160:1-3-02.1	7/1/2016	New	Medicaid premium assistance program (MPAP).
5160:1-3-02.2	7/1/2016	New	Medicare buy-in.
5160:1-3-02.3	8/1/2016	New	Medicaid: coverage for individuals receiving supplemental security income (SSI) benefits.
5160:1-3-02.4	8/1/2016	New	Medicaid: coverage for the categorically needy.
5160:1-3-02.5	8/1/2016	New	Medicaid: supplemental security income (SSI) recipients qualifying under section 1619 of the Social Security Act for continued medical assistance coverage.
5160:1-3-02.6	8/1/2016	New	Medicaid: grandfathering provisions and deemed eligibility.
5160:1-3-02.7	12/12/2016	Rescinded	Medicaid: continuing care communities, life care communities and philanthropic long-term care facilities.
5160:1-3-02.8	12/1/2014		Medicaid: treatment of qualified long-term care insurance policies.
5160:1-3-02.9	8/1/2016	New	Medicaid: disability determination process.
Income
5160:1-3-03.1	8/1/2016	New	Medicaid: income.
5160:1-3-03.2	8/1/2016	New	Medicaid: income exclusions.
5160:1-3-03.3	8/1/2016	New	Medicaid: deeming of income.
5160:1-3-03.5	3/1/2017	New	Medicaid: application of income standards.
5160:1-3-03.6	8/1/2016	Amendment	Medicaid: treatment of rental income.
5160:1-3-03.7	8/1/2016	Amendment	Medicaid: treatment of sick pay and sick leave.
5160:1-3-03.8	8/1/2016	Amendment	Medicaid: in-kind support and maintenance.
5160:1-3-03.10	8/1/2016	New	Medicaid: retirement funds.
Patient Liability & Special Income Level
5160:1-3-04.1	8/1/2016	Amendment	Medicaid: eligibility through the spenddown process.
5160:1-3-04.2	9/1/2017	Rescinded	Medicaid: income computations for determining eligibility using the special income level.
5160:1-3-04.3	9/1/2017	Rescinded	Medicaid: determining patient liability.
5160:1-3-04.4	9/1/2017	Rescinded	Medicaid: income and patient liability determinations for individuals under the assisted living home and community based waiver.
Resources
5160:1-3-05.1	9/1/2017	New	Medicaid: resource requirement.
5160:1-3-05.2	9/1/2017	Amendment	Medicaid: trusts.
5160:1-3-05.3	9/1/2017	New	Medicaid: annuities.
5160:1-3-05.4	8/1/2016	Amendment	Medicaid: cash and checking and savings accounts and time deposits.
5160:1-3-05.5	9/1/2017	New	Medicaid: promissory notes, property agreements, and loans.
5160:1-3-05.6	9/1/2017	New	Medicaid: burial funds and contracts.
5160:1-3-05.7	8/1/2016	New	Medicaid: burial spaces.
5160:1-3-05.8	9/1/2017	Amendment	Medicaid: lump-sum payments.
5160:1-3-05.9	8/1/2016	New	Medicaid: dividends and interest.
5160:1-3-05.10	8/1/2016	New	Medicaid: household goods and personal effects as resources.
5160:1-3-05.11	8/1/2016	Amendment	Medicaid: automobiles and other modes of transportation as resources.
5160:1-3-05.12	9/1/2017	New	Medicaid: life insurance.
5160:1-3-05.13	9/1/2017	New	Medicaid: treatment of the home.
5160:1-3-05.14	8/1/2016	New	Medicaid: resource exclusion.
5160:1-3-05.16	11/2/2014		Medicaid: home replacement exclusion.
5160:1-3-05.17	9/1/2017		Medicaid: life estates.
5160:1-3-05.18	9/12/2016	New	Medicaid: stocks, mutual funds, and bonds.
5160:1-3-05.19	8/1/2016	Amendment	Medicaid: real or personal property essential to self-support.
5160:1-3-05.20	9/1/2017	Amendment	Medicaid: deeming of resources.
Treatment of Resources for IS with a CS
5160:1-3-06.1	9/1/2017	Rescinded	Medicaid: treatment of income and resources of institutionalized individuals.
5160:1-3-06.2	9/1/2017	Rescinded	Medicaid: resource assessment.
5160:1-3-06.3	9/1/2017	Rescinded	Medicaid: treatment of resources for institutionalized individuals with a spouse in the community.
5160:1-3-06.4	9/1/2017	Rescinded	Medicaid: resource budgeting methodology for institutionalized individuals with a spouse in the community.
5160:1-3-06.5	9/1/2017	Rescinded	Medicaid: transfer of resources for institutionalized spouses with a spouse in the community.
Transfer of Resources
5160:1-3-07.1	9/1/2017	Rescinded	Medicaid: social security administration reporting alleged transfer of resources by supplemental security income (SSI) applicants to the Ohio department of medicaid (ODM).
5160:1-3-07.2	9/1/2017	Rescinded	Medicaid: transfer of resources.
5160:1-3-07.3	9/1/2017	Rescinded	Medicaid: disposal of resources for Ohio department of developmental disabilities and/or Ohio department of mental health and addiction services individuals.
MAGI-based Medicaid
5160:1-4-01	8/1/2016	Amendment	MAGI-based medicaid: income and household income.
5160:1-4-02	1/1/2017		MAGI-based medicaid: coverage for children younger than age nineteen.
5160:1-4-03	1/1/2016		MAGI-based medicaid: coverage for Ribicoff and former foster care adults.
5160:1-4-04	1/1/2017		MAGI-based medicaid: coverage for pregnant women.
5160:1-4-05	12/19/2016		MAGI-based medicaid: coverage for a parent or caretaker relative residing with a child.
5160:1-4-06	1/1/2017	New	Medicaid: coverage for indivdiuals in receipt of adoption or foster care assistance.
Chapter 5160:1-5 Medicaid for Other Covered Groups
Special Programs
5160:1-5-01	8/1/2016	New	Medicaid: the residential state supplement (RSS) program.
5160:1-5-02	3/23/2015		Medicaid: breast and cervical cancer project (BCCP).
5160:1-5-02.1	3/23/2015		Medicaid:  breast and cervical cancer project (BCCP) definitions.
5160:1-5-02.2	3/23/2015		Medicaid: breast and cervical cancer project (BCCP): eligibility requirements.
5160:1-5-02.3	3/23/2015		Medicaid: breast and cervical cancer project (BCCP) eligibility period.
5160:1-5-02.4	3/23/2015		Medicaid: breast and cervical cancer project (BCCP): application and redetermination process.
5160:1-5-03	9/1/2017	Amended	Medicaid: medicaid buy-in for workers with disabilities (MBIWD).
5160:1-5-05	3/23/2015		Medicaid: refugee medical assistance (RMA).
5160:1-5-06	8/1/2016	New	Medicaid: alien emergency medical assistance (AEMA).
5160:1-5-07	9/11/2017	New	Medicaid: Specialized recovery services (SRS) program.
Chapter 5160:1-6 Long-Term Care
Long-Term Care Definitions
5160:1-6-01	9/1/2017		Medicaid: eligibility for medicaid payment for long-term care (LTC) services.
5160:1-6-01.1	9/1/2017		Medicaid: definitions relating to eligibility for long-term care services.
Special Resource Rules
5160:1-6-02	9/1/2017		Medicaid: special resource rules when an individual is requesting or receiving medicaid payment for long-term care (LTC) service
5160:1-6-02.1	9/1/2017		Medicaid: home equity limit for individuals requesting or receiving medicaid payment for long-term care (LTC) services.
5160:1-6-02.3	9/1/2017		Medicaid: continuing care communities, life care communities, and philanthropic LTC facilities.
Special Income Rules
5160:1-6-03	9/1/2017		Medicaid: special income rules that may apply when an individual is requesting payment for LTC services
5160:1-6-03.1	9/1/2017		Medicaid: determining financial eligibility for medical assistance using the speical income level (SIL)
5160:1-6-03.2	9/1/2017	New	Medicaid: use of qualified income trusts (QIT).
Treatment of Resources for IS with a CS
5160:1-6-04	9/1/2017		Medicaid: treatment of income and resources for an instituationalized spouse with a spouse in the community
5160:1-6-05	9/1/2017		Medicaid: treatment of income and resources for spouses who are both seeking medicaid payment for LTC services
Transfers of Resources and Purchases
5160:1-6-06	9/1/2017		Medicaid: transfer of assets
5160:1-6-06.1	9/1/2017		Medicaid: treatment of annuity purchases and transactions
5160:1-6-06.2	9/1/2017		Medicaid: treatment of transfers involving a trust.
5160:1-6-06.3	9/1/2017		Medicaid: transfers involving life estates.
5160:1-6-06.4	9/1/2017		Medicaid: transfers involving promissory notes, property agreements, and loans.
5160:1-6-06.5	9/1/2017		Medicaid: restricted medicaid coverage period
5160:1-6-06.6	9/1/2017		Medicaid: undue hardship exemption.
5160:1-6-06.7	9/1/2017		Medicaid: allegations of asset transfers by the social security administration.
5160:1-6-06.8	9/1/2017		Medicaid: disposal of assets of individuals receiving services from the Ohio department of developmental disabilities and/or Ohio department of mental health and addiction services.
Post Eligibility
5160:1-6-07	9/1/2017		Medicaid: post-eligibility treatment of income for individuals in medical institutions.
5160:1-6-07.1	9/1/2017		Medicaid: post-eligibility treatment of income for individuals receiving services through a home and community-based services (HCBS) waiver or the program of all-inclusive care for the elderly (PACE).