Section 5165.52 | Overpayment amounts determined following notice of closure, etc.

• Effective: October 3, 2023
• Latest Legislation: House Bill 33 - 135th General Assembly

(A) On receipt of a written notice under section 5165.50 of the Revised Code of a facility closure or voluntary withdrawal of participation, on receipt of a written notice under section 5165.51 of the Revised Code of a change of operator, or on the effective date of an involuntary termination, the department of medicaid shall estimate the amount of any overpayments made under the medicaid program to the exiting operator, including overpayments the exiting operator disputes, and other actual and potential debts the exiting operator owes or may owe to the department under the medicaid program, including a franchise permit fee.

(B) In estimating the exiting operator's other actual and potential debts to the department under the medicaid program, the department shall use a debt estimation methodology the medicaid director shall establish in rules authorized by section 5165.53 of the Revised Code. The methodology shall provide for estimating all of the following that the department determines are applicable:

(1) Refunds due the department under section 5165.41 of the Revised Code;

(2) Interest owed to the department;

(3) Money owed the department from any outstanding final fiscal audit, including a final fiscal audit for the last state fiscal year or portion thereof in which the exiting operator participated in the medicaid program;

(4) Other amounts the department determines are applicable.

(C) The department shall provide the exiting operator written notice of the department's estimate under division (A) of this section not later than thirty days after whichever of the following applies: the department receives the notice under section 5165.50 of the Revised Code of the facility closure or voluntary withdrawal of participation, the department receives the notice under section 5165.51 of the Revised Code of the change of operator, or the effective date of the involuntary termination. The department's written notice shall include the basis for the estimate.

Last updated October 6, 2023 at 10:43 AM

Available Versions of this Section

• September 29, 2013 – House Bill 59 - 130th General Assembly
• November 22, 2017 – Amended by House Bill 49 - 132nd General Assembly
• October 3, 2023 – Amended by House Bill 33 - 135th General Assembly