3701-44-05 Eligibility for benefits under the Ryan White part B program.

(A) To be eligible for benefits under the Ryan White part B program, an individual shall meet all of the following requirements:

(1) The individual must be an Ohio resident;

(2) The individual must have a verified HIV infection; and

(3) The individual or individual’s family must have a gross income, excluding taxes and any mandatory retirement deduction that meets the financial guidelines established by the director. The financial guidelines shall be provided to the HIV medical case managers and published on the department’s website at www.odh.ohio.gov/odhPrograms/chss/aids/aids1.aspx by the first of April of each year. The financial guidelines shall be based on the amount of funding available for the Ryan White part B program and percentage of the poverty income.

(B) The HIV medical case manager for the area where the applicant resides shall determine whether the applicant meets the requirements specified in paragraph (A) of this rule. Upon determining that the applicant is eligible for benefits, the HIV medical case manager shall assign the eligible individual an identification number and shall report the individual’s number to the director and the third-party administrator responsible for making payments under rule 3701-44-04 of the Administrative Code.

(C) The director or HIV medical case manager may deny an individual’s application and future applications or terminate an individual’s eligibility if the director or HIV medical case manager determines that the individual submitted false information related to the application for Ryan White part B benefits or abused approved benefits.

Replaces: 3701-44-05, 3701-44-11

Effective: 08/02/2009

R.C. 119.032 review dates: 08/01/2014

Promulgated Under: 119.03

Statutory Authority: 3701.241

Rule Amplifies: 3701.241

Prior Effective Dates: 9/23/91 (Emer), 12/22/91, 5/20/1999, 7/20/2001