Effective: September 29, 2013
Latest Legislation: House Bill 59 - 130th General Assembly
(A) The medicaid director shall adopt rules under section 5160.02 of the Revised Code implementing sections 5160.45 to 5160.481 of the Revised Code and governing the custody, use, disclosure, and preservation of the information generated or received by the department of medicaid, county departments of job and family services, other state and county entities, contractors, grantees, private entities, or officials participating in the administration of medical assistance programs. The rules shall be adopted in accordance with Chapter 119. of the Revised Code. The rules may define who is an "authorized representative" for purposes of sections 5160.45 and 5160.46 of the Revised Code. The rules shall specify conditions and procedures for the release of information, which may include both of the following:
(1) Permitting a provider of a service under a medical assistance program limited access to information that is essential for the provider to render the service or to bill for the service rendered;
(2) Permitting a contractor, grantee, or other state or county entity limited access to information that is essential for the contractor, grantee, or entity to perform administrative or other duties on behalf of the department or a county department.
(B) The department of aging, when investigating a complaint under section 173.20 of the Revised Code, shall be granted any limited access permitted in the rules authorized by division (A)(1) of this section.
A contractor, grantee, or entity given access to information pursuant to the rules authorized by division (A)(2) of this section is bound by the director's rules. Disclosure of the information by the contractor, grantee, or entity in a manner not authorized by the rules is a violation of section 5160.45 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.