Ohio Revised Code
Chapter 5160 | Medical Assistance Programs
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 department to determine any period that the individual or the individual's spouse or dependent may have been covered by the third party and the nature of the coverage, a third party shall provide, as the department so chooses, information or access to information, or both, in the third party's electronic data system on the department's request and in accordance with division (C) of this section.
(C)(1) If the department chooses to receive information directly, the third party shall provide the information under all of the following circumstances:
(a) In a medium, format, and manner prescribed in rules authorized by section 5160.43 of the Revised Code;
(b) Free of charge;
(c) Not later than the end of the thirtieth day after the department makes its request, unless a different time is agreed to by the director in writing.
(2) If the department chooses to receive access to information, the third party shall provide access by a method prescribed in rules authorized by section 5160.43 of the Revised Code. In facilitating access, the department may enter into a trading partner agreement with the third party to permit the exchange of information via "ASC X 12N 270/271 Health Care Eligibility Benefit Inquiry and Response" transactions.
(D) All of the following apply with respect to information provided by a third party to the department under this section:
(1) The information is confidential and not a public record under section 149.43 of the Revised Code.
(2) The release of information to the department is not to be considered a violation of any right of confidentiality or contract that the third party may have with covered persons including, but not limited to, contractees, beneficiaries, heirs, assignees, and subscribers.
(3) The third party is immune from any liability that it may otherwise incur through its release of information to the department.
The department shall limit its use of information gained from third parties to purposes directly connected with the administration of the medicaid program and the child support program authorized by Title IV-D of the "Social Security Act," 42 U.S.C. 651 et seq.
(E) No third party shall disclose to other parties or make use of any information regarding medical assistance recipients that it obtains from the department, except in the manner provided in rules authorized by section 5160.43 of the Revised Code.

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