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 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 whether it indicates a change in circumstances that may affect eligibility for a medical assistance program;
(b) Take appropriate action.
( 2) Division (A)(1) of this section applies only to the extent information described in division (A) of section 5160.29 of the Revised Code is available to the department or entity.
(B) If the department of medicaid or an entity with which the department has entered into an agreement under section 5160.30 of the Revised Code receives information concerning a medical assistance recipient that indicates a change in circumstances that may affect the recipient's continued eligibility for the medical assistance program in which the recipient is enrolled, the department or entity shall take appropriate action, including verifying unclear information, providing prior written notice of a change or adverse action, and notifying the recipient of the right to appeal under section 5160.31 of the Revised Code.
Structure Ohio Revised Code
Chapter 5160 | Medical Assistance Programs
Section 5160.01 | Definitions.
Section 5160.011 | References to Department or Director of Other Agencies.
Section 5160.021 | Adoption of Rules.
Section 5160.03 | Authority of Medicaid Director.
Section 5160.04 | Assistant Director; Powers and Duties.
Section 5160.05 | Appointment of Employees.
Section 5160.051 | Filling Positions With Peculiar and Exceptional Qualifications.
Section 5160.052 | Procedures and Formats for Section 109.5721 Notices.
Section 5160.06 | Fidelity Bonds.
Section 5160.10 | Expending Funds.
Section 5160.11 | State Health Care Grants Fund.
Section 5160.13 | Maximizing Receipt of Federal Revenue.
Section 5160.16 | Appointment of Agents.
Section 5160.20 | Audits and Investigations; Authority of Department.
Section 5160.21 | Audit of Medical Assistance Recipient.
Section 5160.22 | Examination of Records Regarding Medical Assistance Programs.
Section 5160.23 | Audit Costs.
Section 5160.29 | Verification of Eligibility for Medical Assistance Program.
Section 5160.291 | Changes Affecting Eligibility.
Section 5160.292 | Medicaid Eligibility Fraud.
Section 5160.293 | Construction.
Section 5160.30 | Administrative Activities for Medical Assistance Programs.
Section 5160.31 | Appeals Regarding Determination of Eligibility for Medical Assistance Program.
Section 5160.34 | Medical Assistance Programs With Prior Authorization Requirements.
Section 5160.35 | Recovery of Medical Support Definitions.
Section 5160.37 | Right of Recovery for Cost of Medical Assistance.
Section 5160.371 | Disclosure of Third-Party Payer Information.
Section 5160.38 | Assignment of Rights to Department.
Section 5160.39 | Third-Party Cooperation Regarding Liability Information.
Section 5160.40 | Third-Party Duties; Medicaid Managed Care Organizations.
Section 5160.401 | Finality of Payments.
Section 5160.41 | Excluded Considerations for Third-Party Medical Assistance.
Section 5160.42 | Sanctions Against Third Parties for Violations.
Section 5160.43 | Adoption of Rules Regarding Recovery of Costs.
Section 5160.45 | Disclosure of Medical Assistance Information.
Section 5160.46 | Authorization Form.
Section 5160.48 | Rules for Conditions and Procedures for the Release of Information.
Section 5160.481 | Adoption of Rules by Other Agencies.
Section 5160.50 | Refugee Medical Assistance Program.
Section 5160.99 | Penalty for Unlawful Disclosure of Information.