Section 5160.37 | Right of Recovery for Cost of Medical Assistance.
Effective: September 29, 2017 Latest Legislation: House Bill 49 – 132nd General Assembly (A) A medical assistance recipient’s enrollment in a medical assistance program gives an automatic right of recovery to the department of medicaid and a county department of job and family services against the liability of a third party for the cost of […]
Section 5160.371 | Disclosure of Third-Party Payer Information.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly In addition to the requirement of division (C) of section 5160.37 of the Revised Code to cooperate with the department of medicaid and county department of job and family services, a medical assistance recipient and the recipient’s attorney, if any, shall cooperate […]
Section 5160.38 | Assignment of Rights to Department.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) The application for, or enrollment in, a medical assistance program constitutes an automatic assignment of rights specified in division (B) of this section to the department of medicaid. This assignment includes the rights of the medical assistance recipient and also the […]
Section 5160.39 | Third-Party Cooperation Regarding Liability Information.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) A third party shall cooperate with the department of medicaid in identifying individuals for the purpose of establishing third party liability regarding medical assistance programs. (B) In furtherance of the requirement in division (A) of this section and to allow the […]
Section 5160.40 | Third-Party Duties; Medicaid Managed Care Organizations.
Effective: September 29, 2017 Latest Legislation: House Bill 49 – 132nd General Assembly (A) As used in this section, “business day” means any day of the week excluding Saturday, Sunday, and a legal holiday, as defined in section 1.14 of the Revised Code. (B) Subject to divisions (C) and (D) of this section, a third […]
Section 5160.401 | Finality of Payments.
Effective: September 29, 2017 Latest Legislation: House Bill 49 – 132nd General Assembly (A) A payment made by a third party under division (B)(5) of section 5160.40 of the Revised Code on a claim for payment of a medical item or service provided to a medical assistance recipient is final on the date that is […]
Section 5160.41 | Excluded Considerations for Third-Party Medical Assistance.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly No third party shall consider whether an individual is eligible for or enrolled in a medical assistance program when either of the following applies: (A) The individual seeks to obtain a policy or enroll in a plan or program operated or administered […]
Section 5160.42 | Sanctions Against Third Parties for Violations.
Effective: September 29, 2013 Latest Legislation: House Bill 59 – 130th General Assembly (A) If a third party violates section 5160.39, 5160.40, or 5160.41 of the Revised Code, a governmental entity that is responsible for issuing a license, certificate of authority, registration, or approval that authorizes the third party to do business in this state […]
Section 5160.29 | Verification of Eligibility for Medical Assistance Program.
Effective: July 1, 2019 Latest Legislation: House Bill 119 – 132nd General Assembly (A) As part of the process of determining an individual’s eligibility for a medical assistance program, at least all of the following information about the individual shall be verified: (1) Identity; (2) Citizenship and alien eligibility; (3) Social security number; (4) State […]
Section 5160.291 | Changes Affecting Eligibility.
Effective: July 1, 2019 Latest Legislation: House Bill 119 – 132nd General Assembly (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 […]