Lawriter - OAC - 5101:9-6-05.1 Medicaid enhanced eligibility allocation.

5101:9-6-05.1 Medicaid enhanced eligibility allocation.

(A) On behalf of the department of medicaid, the Ohio department of job and family services (ODJFS ) issues the medicaid enhanced eligibility allocation to the county department of job and family services (CDJFS). This funding is provided to meet matching fund requirements for costs related to the implementation and operation of the integrated eligibility (IE) system.

(B) The funding for the medicaid enhanced eligibility allocation consists of one hundred per cent state funds, and is in addition to the county mandated share required by section 5101.16 of the Revised Code and detailed in rule 5101:9-6-31 of the Administrative Code.

Federal medicaid enhanced eligibility funding is passed through to the CDJFS at the federal financial participation (FFP) rate of seventy-five per cent.

(C) ODJFS will communicate the funding and liquidation periods for this allocation through the county finance information system (CFIS). The CDJFS must expend funds by the end of the funding period and disburse and report expenditures no later than the end of the liquidation period.

(D) ODJFS uses the same methodology to distribute available medicaid enhanced eligibility funds as for the income maintenance allocations outlined in rule 5101:9-6-05 of the Administrative Code.

(E) The CDJFS may code the following expenditures against this funding:

(1) Eligibility determination activities including:

(a) Initial determination and redetermination of medicaid eligibility;

(b) Manual conversion of cases into the IE system and desk review of cases in preparation for conversion in the IE system; and

(c) Consumer inquiries and assistance with the dual application process (CRISe and the IE system); and

(d) Ongoing case maintenance activities (including receipt of data related to the ongoing eligibility and maintenance of eligibility, address changes, income changes, household composition changes, etc) to support IE system cases including intake activities related to renewals; but

(e) The CDJFS may not use this allocation when the work is exclusively in the CRISe system.

(2) Operational readiness training and testing activities associated with the training of eligibility workers directly engaged in the operation of the IE system . Activities include:

(a) Policy training on new modified adjusted gross income (MAGI) rules;

(b) System training and testing on the (IE) system; and

(c) Business process training on eligibility determination and case maintenance in both CRISe and the (IE) system.

(d) The CDJFS may claim training and testing activities at a seventy-five per cent federal participation rate for the entire grant availability period.

(F) The CDJFS shall direct charge contracts and purchased services, including travel and training costs, costs related to the implementation and operation of the integrated eligibility system to this allocation. The CDJFS shall capture administrative costs through the random moment sample (RMS) process as detailed in rule 5101:9-7-20 of the Administrative Code.

(G) Allocation redistribution is pursuant to rule 5101:9-6-02 of the Administrative Code. CDJFS may move eligible expenditures in excess of this allocation to the county's income maintenance (IM) allocation by performing a coding adjustment. Twenty-five per cent will be charged to the county's IM allocation and seventy-five per cent will be charged to the federal medicaid pass-through funding. If a county exceeds the IM allocation, the CDJFS shall provide matching funds in order to qualify for federal pass-through funding.

(H) The CDJFS shall report expenditures as described in rule 5101:9-7-29 of the Administrative Code.

(I) The definitions, requirements, and responsibilities contained in rule 5101:9-6-50 of the Administrative Code are applicable to this rule.

Effective: 04/14/2014
Promulgated Under: 111.15
Statutory Authority: 5101.02
Rule Amplifies: 5101.02
Prior Effective Dates: 10/7/13