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Resource Use (Cost/Utilization) Measurement and Reporting in Ohio

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Healthcare providers and facilities are subject to reporting requirements relating to cost and utilization of health care services provided within the state of Ohio.  Hospitals must annually submit utilization data for both inpatient and outpatient services, including the total number of discharges and admissions; such information will be publicly available.1  Each hospital participating in the Medicaid program must annually submit cost reports, including all information necessary for the proper determination of costs payable under Medicaid, including financial records and statistical data.2  Each nursing facility and intermediate care facility for the mentally retarded must annually submit cost reports.3  Managed care organizations under contract with the department of job and family services must maintain cost and utilization records and data for hospital services provided to Medicaid recipients.4

 

Footnotes

  • 1. Ohio Rev. Code § 3727.34
  • 2. Ohio Admin. Code 5101:3-2-23
  • 3. Ohio Admin. Code 5101:3-3-20
  • 4. Ohio Rev. Code § 5111.175

 

Resource Use (Cost/Utilization) Measurement and Reporting in Ohio

Subtopic Statute/Regulation Description
Provider cost reporting Annual cost report – Ohio Rev. Code Ann. § 5165.10 Each provider must annually file with the department of job and family services a cost report for each of the provider’s nursing facilities and...
Annual report – Ohio Rev. Code Ann. § 5119.60 The department of health must annually report the services the department offers and how appropriated funds have been spent.  The report will...
Hospital to disclose data to nongovernmental patients – Ohio Rev. Code Ann. § 3727.34 Each hospital must annually submit to the director of health the following information pertaining to inpatient services for patients in each of the...
Nursing facilities (NFs): Medicaid cost report filing, record retention, and disclosure requirements – Ohio Admin. Code 5160-3-20 Each nursing facility and intermediate care facility for the mentally retarded participating in the Medicaid program must electronically file an...
Performance information to be posted on internet – Ohio Rev. Code Ann. § 3727.39 The director of health must make performance and price information submitted by hospitals publicly available on an internet website.  In posting...
Price information list – Ohio Rev. Code Ann. § 3727.42 Each hospital must compile and make available for public inspection, a price information list that must be periodically updated.  The price...
Financial information data collection Cost reports – Ohio Admin. Code 5160-2-23 “Cost reports”   Each hospital participating in the Medicaid program must electronically submit periodic cost reports that generally...
Resource Use (Cost/Utilization) Measurement and Reporting Hospital registration and reporting requirements – Ohio Admin. Code 3701-59-05 By March 1st of each year, every hospital must register with and report to the department of health the following information for the previous...
Records for determining costs – Ohio Rev. Code Ann. § 5167.26 Managed care organizations under contract with the department to provide, or arrange for the provision of, hospital services to Medicaid recipients...
Click on the individual state law in the table above to see our summary of the individual law.


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