Effective: September 29, 2015
Latest Legislation: House Bill 64 - 131st General Assembly
(A)(1) A buckeye account shall be established for each healthy Ohio program participant. Subject to division (A)(2) of this section, a participant's buckeye account shall consist of both of the following:
(a) The medicaid funds deposited into the account under division (B) of this section and division (A) of section 5166.404 of the Revised Code;
(b) Contributions made by the participant and on the participant's behalf under divisions (C) and (D) of this section.
(2) A buckeye account shall not have more than ten thousand dollars in it at one time.
(B) Subject to division (A)(2) of this section, one thousand dollars of medicaid funds shall be deposited each year into the buckeye account of a healthy Ohio program participant. Except in the case of a participant who is not required to make contributions to the participant's buckeye account, the initial deposit of medicaid funds into a participant's buckeye account shall not occur until the initial contribution to the participant's account is made under division (C) or (D) of this section.
(C)(1) Subject to divisions (A)(2), (D), and (F) of this section, a healthy Ohio program participant shall contribute each year to the participant's buckeye account the lesser of the following:
(a) Two per cent of the participant's annual countable family income;
(b) Ninety-nine dollars.
(2) A participant's contributions to the participant's buckeye account may be made in monthly installments. A monthly installment payment shall be considered an initial contribution.
(D)(1) Subject to division (D)(2) of this section, the following may make contributions to a healthy Ohio program participant's buckeye account on the participant's behalf:
(a) The participant's employer, but only up to fifty per cent of the contributions the participant is required to make;
(b) A not-for-profit organization, but only up to seventy- five per cent of the contributions the participant is required to make;
(c) The managed care organization that offers the health plan in which the participant enrolls under the healthy Ohio program, but both of the following apply to such contributions:
(i) They shall be used only to pay the costs for the participant to participate in a health-related incentive available under the health plan, such as completion of a risk assessment or participation in a smoking cessation program.
(ii) They cannot reduce the amount the participant is required to contribute.
(2) Contributions made on a participant's behalf under divisions (D)(1)(a) and (b) of this section shall be coordinated in a manner so that the participant makes at least twenty-five per cent of the contributions the participant is required to make.
(E) Except in the case of a healthy Ohio program participant who is not required to make contributions to the participant's buckeye account, a participant shall not begin to receive benefits under the healthy Ohio program until the initial contribution to the participant's buckeye account is made under division (C) or (D) of this section.
(F)(1) The following portion of the amount that remains in a healthy Ohio program participant's buckeye account at the end of a year shall carry forward in the account for the next year:
(a) If the participant satisfies requirements regarding preventative health services established in rules authorized by section 5166.409 of the Revised Code, the entire amount;
(b) If division (F)(1)(a) of this section does not apply, the amount representing the contributions to the account.
(2) The amount of contributions that must be made to a participant's buckeye account for a year shall be reduced by the amount that is carried forward under division (F)(1) of this section. If the amount carried forward is at least the amount of contributions that division (C) of this section requires for that year, no contributions are required to be made for the participant that year.
(G) A buckeye account shall be used only for the following:
(1) To pay for the expenses for which a healthy Ohio program debit swipe card may be used as specified in division (A) of section 5166.403 of the Revised Code;
(2) Other purposes authorized by rules adopted under section 5166.409 of the Revised Code.
(H) The department of medicaid shall provide for a healthy Ohio program participant to receive monthly statements showing the current amount in the participant's buckeye account and the previous month's expenditures from the account. The statement shall specify how much of the amount in the participant's buckeye account is the core portion and how much is the noncore portion. The department may arrange for the statements to be provided in an electronic format.
Structure Ohio Revised Code
Chapter 5166 | Federal Medicaid Waiver Programs
Section 5166.01 | Definitions.
Section 5166.02 | Rules Governing Medicaid Waiver Components.
Section 5166.03 | Notice of Intent to Request Medicaid Waiver.
Section 5166.04 | Home and Community-Based Services Medicaid Waiver Components.
Section 5166.05 | Review of Plans of Care and Individual Service Plans.
Section 5166.06 | Agency Records of Costs of Medicaid Waiver Components.
Section 5166.07 | Agency Accountable for Medicaid Waiver Components Funds.
Section 5166.08 | Agency Contracting for Medicaid Waiver Components; Assurance of Compliance.
Section 5166.10 | Transfer of Enrollee in One Medicaid Waiver Component to Another.
Section 5166.12 | Determination Regarding Continuation of the Ohio Home Care Waiver Program.
Section 5166.121 | Home First Component for the Ohio Home Care Waiver Program.
Section 5166.14 | Unified Long-Term Services and Support Medicaid Waiver Component.
Section 5166.16 | Integrated Care Delivery System Medicaid Waiver.
Section 5166.161 | Home and Community-Based Services for Holocaust Survivors.
Section 5166.20 | Additional Medicaid Waiver Components for Home and Community-Based Services.
Section 5166.21 | Transitions Developmental Disabilities Waiver.
Section 5166.22 | Allocating Enrollment Numbers to County Board of Developmental Disabilities.
Section 5166.30 | Coverage of Home Care Attendant Services.
Section 5166.301 | Home Care Attendant Services Providers.
Section 5166.302 | Continuing Education Requirements for Home Care Attendants.
Section 5166.303 | Responsibilities of Home Care Attendants.
Section 5166.304 | Nursing Assistance by Home Care Attendants.
Section 5166.305 | Nursing Assistance by Home Care Attendants; Consent and Authorization.
Section 5166.306 | Nursing Assistance by Home Care Attendants; Written Statement Providing Consent.
Section 5166.307 | Nursing Assistance by Home Care Attendants; Written Statement of Authorization.
Section 5166.308 | Nursing Assistance by Home Care Attendants; Unauthorized Actions.
Section 5166.3010 | Authorized Representative.
Section 5166.32 | Medicaid Waiver for Individuals With Cystic Fibrosis.
Section 5166.40 | Definitions.
Section 5166.401 | Enrolllment for Healthy Ohio Program Participants.
Section 5166.402 | Buckeye Accounts for Participants.
Section 5166.403 | Debit Swipe Cards.
Section 5166.404 | Points Award System.
Section 5166.405 | Cessation of Participation.
Section 5166.406 | Exhaustion of Payout Limits.
Section 5166.407 | Disqualification for Medicaid; Disposition of Remainder in Buckeye Account.
Section 5166.408 | Referral to Workforce Development Agency.