Ohio Revised Code Search

...As used in this chapter: (A) "Dual eligible individual" has the same meaning as in the "Social Security Act," section 1915(h)(2)(B), 42 U.S.C. 1396n(h)(2)(B). A dual eligible individual is a medicare-medicaid enrollee (MME). (B) "Exchange" has the same meaning as in 45 C.F.R. 155.20. (C) "Federal financial participation" means the federal government's share of expenditures made by an entity in implementing a medic...

...rences to the department or director of public welfare, department or director of human services, department or director of job and family services, department or director of children and youth, office of medical assistance, or medical assistance director in any statute, rule, contract, grant, or other document is deemed to refer to the department of medicaid or medicaid director, as the case may be, to the extent th...

...The medicaid director shall adopt rules as necessary to implement this chapter.

...bject to the notice, hearing, or other requirements of sections 119.06 to 119.13 of the Revised Code.

...The medicaid director is the executive head of the department of medicaid. All duties conferred on the department by law or order of the director are under the director's control and shall be performed in accordance with rules the director adopts.

...The medicaid director shall appoint one assistant director for the department of medicaid. The assistant director shall exercise powers, and perform duties, as ordered by the medicaid director. The assistant director shall act as the medicaid director in the medicaid director's absence or disability and when the position of medicaid director is vacant.

...The medicaid director may appoint such employees as are necessary for the efficient operation of the department of medicaid. The director may prescribe the title and duties of the employees.

...If the medicaid director determines that a position with the department of medicaid can best be filled in accordance with division (A)(2) of section 124.30 of the Revised Code or without regard to a residency requirement established by a rule adopted by the director of administrative services, the medicaid director shall provide the director of administrative services certification of the determination.

...The department of medicaid shall collaborate with the superintendent of the bureau of criminal identification and investigation to develop procedures and formats necessary to produce the notices described in division (D) of section 109.5721 of the Revised Code in a format that is acceptable for use by the department. The medicaid director may adopt rules under section 5160.02 of the Revised Code necessary for such co...

...charged with custody or control of any public money or property or who is required to give bond, to give a bond, properly conditioned, in a sum to be fixed by the director which when approved by the director, shall be filed in the office of the secretary of state. The cost of such bonds, when approved by the director, shall be paid from funds available for the department. The bonds required or authorized by th...

...The medicaid director may expend funds appropriated or available to the department of medicaid from persons and government entities. For purposes of this section, the director may enter into contracts or agreements with persons and government entities and make grants to persons and government entities. To the extent permitted by federal law, the director may advance funds to a grantee when necessary for the gra...

...f such projects, and shall comply with requirements the foundations have stipulated in their agreements with the department as to the purposes for which the money may be expended.

...eriod of time; (5) Establish any other requirements determined by the department to be necessary for the efficient administration of the agreement. (F) An entity that receives federal financial participation pursuant to this section for a program aiding children and their families shall establish a process for collaborative planning with the department for the use of the funds to improve and expand the progra...

...lso directly enter into contracts with public entities providing revenue maximization services.

...The department of medicaid may appoint and commission any competent person to serve as a special agent, investigator, or representative to perform a designated duty for and on behalf of the department. Specific credentials shall be given by the department to each person so designated, and each credential shall state the following: (A) The person's name; (B) The agency with which the person is connected; (C) ...

...he subject of the audit report is not a public record under section 149.43 of the Revised Code. (D) The medicaid director may adopt rules under section 5160.02 of the Revised Code as necessary to implement this section. The rules shall be adopted in accordance with section 111.15 of the Revised Code as if they were internal management rules.

...On the request of the medicaid director, the auditor of state may conduct an audit of any medical assistance recipient. If the auditor decides to conduct an audit under this section, the auditor shall enter into an interagency agreement with the department of medicaid that specifies that the auditor agrees to comply with section 5160.45 of the Revised Code with respect to any information the auditor receives pu...

...(A) The auditor of state and attorney general, or their designees, may examine any records, whether in computer or printed format, in the possession of the medicaid director or any county director of job and family services, regarding medical assistance programs. The auditor of state and attorney general shall do both of the following regarding the records: (1) Provide safeguards that restrict access to the re...

...The auditor of state is responsible for the costs the auditor incurs in carrying out the auditor's duties under sections 5160.21 and 5160.22 of the Revised Code.

...ment status in other state-administered public assistance programs within and outside the state. ( B) As part of the process of determining an individual's eligibility for a medical assistance program, each applicant, or a person acting on the applicant's behalf, shall verify the applicant's identity. (C)(1) The department of medicaid shall sign a memorandum of understanding with any department, agency, or divisi...

...(A)(1) As information described in division (A) of section 5160.29 of the Revised Code is received by the department of medicaid or an entity with which the department has entered into an agreement under section 5160.30 of the Revised Code, the department or entity shall do both of the following on at least a quarterly basis and in accordance with federal regulations: (a) Review the information to determine whet...

...If a violation of section 2913.401 of the Revised Code or a similar offense is suspected in the process of determining or redetermining a medical assistance recipient's eligibility, the case shall be referred for investigation to the county prosecutor of the county in which the medical assistance recipient resides, referred for an administrative disqualification hearing, or both.

...Nothing in sections 5160.29 to 5160.292 of the Revised Code prevents the department of medicaid or any entity with which the department has entered into an agreement under section 5160.30 of the Revised Code from doing either of the following: (A) Receiving or reviewing information related to individuals' eligibility for a medical assistance program beyond the information specified in division (A) of section 5160....

...(A) Except as provided in divisions (B) and (C) of this section, the department of medicaid may accept applications, determine eligibility, redetermine eligibility, and perform related administrative activities for medical assistance programs. (B) The department may enter into agreements with one or more agencies of the federal government, the state, other states, and local governments of this or other states...

...(A) A medical assistance recipient may appeal a decision regarding the recipient's eligibility for a medical assistance program or services available to the recipient under a medical assistance program. (B) Regarding appeals authorized by this section, the department of medicaid shall do one or more of the following: (1) Administer an appeals process similar to the appeals process established under section 51...