5101:1-37-04 Medicaid: replacement checks.

(A) The purpose of this rule is to describe how the administrative agency replaces a check that is reported missing or damaged.

(B) Definitions:

(1) "Check" or "checks," for the purposes of this rule, means a payment issued to a payee for the residential state supplement (RSS), for reimbursement for medicaid-covered expenses, or for other payments related to medical assistance programs administered by the Ohio department of job and family services (ODJFS).

(2) "Holder" means the person who acquired possession of the check from the payee and is entitled to receive payment for the check.

(3) "Payee" means the individual to whom the check is payable.

(C) Payee responsibilities and rights. The payee shall:

(1) Notify the administrative agency of the missing or damaged check. The payee should notify the administrative agency in the county in which the recipient resides.

(2) Return the damaged check to the administrative agency.

(3) Complete the necessary forms and paperwork.

(4) Provide identification.

(5) Provide a copy of a police report, if the payee is alleging the check was stolen.

(6) Have the right to request a fair hearing, as described in division 5101:6 of the Administrative Code.

(D) Administrative agency responsibilities. The administrative agency shall:

(1) Verify the payee has met the requirements of paragraph (C) of this rule.

(2) Check the electronic eligibility system issuance history to complete the following steps. For checks not generated by the electronic eligibility system, contact the ODJFS for assistance in completing the following steps.

(a) Verify that a check was issued to the payee.

(b) Determine if a missing check was mailed to the payee's current address. If it was not, correct the address in the electronic eligibility system. Redirect the check, if possible.

(c) Determine if a check was canceled, redirected, voided, or redeemed. If the issuance history shows the check was:

(i) Canceled, issue a replacement check through the electronic eligibility system benefit issuance subsystem.

(ii) Redirected, advise the payee to allow five working days from the redirect date for delivery.

(iii) Voided, issue a replacement check through the electronic eligibility system benefit issuance subsystem.

(iv) Redeemed,

(a) Instruct the payee to complete forms JFS 02132, "Affidavit in Support of Application for Replacement Warrant" (rev. 11/2000) and the state of Ohio office of budget and management "Handwriting Specimens Claim for Alleged Forgery of Payee(s) Warrant" (rev. 06/2007).

(b) Forward the originals and one copy of each completed form to the ODJFS bureau of accounting, accounts receivable section.

(c) Issue a replacement check through the electronic eligibility system benefit issuance subsystem. If the payee alleges the check was stolen, collect a copy of the police report from the payee prior to issuing the replacement check.

(v) Not canceled, redirected, voided, or redeemed, and it has been five or more working days since the check mailing or redirect date, the administrative agency shall:

(a) Immediately telephone the ODJFS bureau of accounting, accounting information section to request payment be stopped on the check, if the payee had endorsed the check prior to it being lost or stolen, or

(b) Enter a stop payment request in the electronic eligibility system, if the payee had not endorsed the check prior to being lost or stolen.

(c) Instruct the payee to complete forms JFS 02132 and the state of Ohio office of budget and management, "Handwriting Specimens Claim for Alleged Forgery of Payee(s) Warrant". Retain the completed forms in the case record. These forms shall be forwarded to the ODJFS bureau of accounting, accounts receivable section if the original check is cashed.

(d) Issue a replacement check through the electronic eligibility system benefit issuance subsystem. If the payee alleges the original check was stolen, collect a copy of the police report from the payee prior to issuing the replacement check.

(3) Issue a replacement check within fourteen days of when a payee reports a damaged check is unable to be cashed.

(a) Collect the damaged check from the payee. If the check has been torn or mutilated, the payee must be able to surrender the major part of the check.

(b) Instruct the payee to complete and sign the JFS 02132.

(c) Attach the damaged check to the JFS 02132, write the words "damaged check" across the top of the form, and forward them to the ODJFS bureau of accounting, accounts receivable section.

(d) Issue a replacement check through the electronic eligibility system benefits issuance subsystem.

(4) Obtain additional samples of the payee's handwriting when requested by ODJFS. This additional sample can be copies of the payee's existing signatures in the case record or an additional state of Ohio office of budget and management, "Handwriting Specimens Claim for Alleged Forgery of Payee(s) Warrant" completed by the payee. The handwriting sample shall be returned, along with a copy of the ODJFS notice requesting the additional sample, to the ODJFS bureau of accounting, accounts receivable section.

(5) Meet with the payee when notified by ODJFS that the handwriting analysis indicates the payee endorsed the original check. During the interview, if the payee:

(a) Acknowledges endorsing and cashing the original check, the administrative agency shall recover the overpayment in accordance with rule 5101:1-38-20 of the Administrative Code.

(b) Denies endorsing and cashing the original check, the administrative agency may file charges against the payee through the county prosecutor, in accordance with section 2913.02 or 2913.401 of the Revised Code. Prior to referring the case to the county prosecutor, the administrative agency shall submit a written request to ODJFS for a report of the handwriting analysis. The case may be referred to the county prosecutor once the report is received.

(6) Act on any overpayment notifications from ODJFS or the county prosecutor in accordance with rule 5101:1-38-20 of the Administrative Code.

(7) Act on checks reported by the holder as missing after being cashed by the payee. Check the electronic eligibility system issuance history and with the ODJFS to verify the check has not been redeemed by the treasurer of state.

(a) If the check has been redeemed, a replacement check cannot be issued. The administrative agency shall obtain a copy of the redeemed check and forward it to the holder in due course.

(b) If the check does not show in the electronic eligibility system as being redeemed, the administrative agency shall:

(i) Immediately telephone the ODJFS bureau of accounting, accounting information section and order payment on the check stopped.

(ii) Complete an AUD 8184, "Auditor of State Handwriting Specimens Claim for Alleged Forgery of Payee(s) Warrant" (rev. 06/2007), or its equivalent. This form shall be signed by the holder. The administrative agency shall assist the holder in completing the form.

(iii) Forward the original and one copy of the AUD 8184, or its equivalent, to the ODJFS bureau of accounting, accounting information section.

(iv) Issue a replacement check through the electronic eligibility system benefit issuance subsystem. If the holder alleges the original check was stolen, collect a copy of the police report from the holder prior to issuing the replacement check.

Replaces: 5101:1-37-04

Effective: 11/01/2009
R.C. 119.032 review dates: 11/01/2014
Promulgated Under: 111.15
Statutory Authority: 5111.01 , 5111.011
Rule Amplifies: 5111.01 , 5111.011 , 2913.02 , 2913.401
Prior Effective Dates: 5/1/71, 5/1/75, 2/1/84 (temp.), 5/1/84, 6/1/84, 4/19/85, 1/1/86 (Emer.), 2/3/86 (Emer.), 4/1/86, 10/1/88 (Emer.), 12/20/88, 10/1/91 (Emer.), 12/20/91, 1/1/94 (Emer.), 3/18/94, 1/1/95, 1/1/96, 7/1/98, 10/1/98, 10/1/02