173.77 Application for participation in program.

Application for participation in the Ohio’s best Rx program shall be made in accordance with rules adopted by the department of aging under section 173.83 of the Revised Code. When applying for participation, an individual may include application for participation by the individual’s spouse and children. An individual’s guardian or custodian may apply on behalf of the individual.

When submitting an application, the applicant shall include the information and documentation specified in the department’s rules as necessary to verify eligibility for the program. The application may be submitted on a paper form prescribed and supplied by the department or pursuant to any other application method the department makes available for the program, including methods that permit an individual to apply by telephone or through the internet.

An applicant shall attest that the information and documentation the applicant submits with an application is accurate to the best knowledge and belief of the applicant. In the case of a paper application form, the applicant’s signature shall be used to certify that the applicant has attested to the accuracy of the information and documentation. In the case of other application methods, the application certification process specified in the department’s rules shall be used to certify that the applicant has attested to the accuracy of the information and documentation.

The department shall inform each applicant that knowingly making a false statement in an application is falsification under section 2921.13 of the Revised Code, a misdemeanor of the first degree. In the case of a paper application form, the department shall provide the information by including on the form a statement printed in bold letters.

Effective Date: 07-01-2007