Ohio Revised Code
Chapter 5166 | Federal Medicaid Waiver Programs
Section 5166.405 | Cessation of Participation.

Effective: September 29, 2017
Latest Legislation: House Bill 49 - 132nd General Assembly
(A) A healthy Ohio program participant's participation in the program shall cease if any of the following applies:
(1) Unless the participant is pregnant, a monthly installment payment to the participant's buckeye account is sixty days late.
(2) The participant fails to submit documentation needed for a redetermination of the participant's eligibility for medicaid before the sixty-first day after the documentation is requested.
(3) The participant becomes eligible for medicaid on a basis other than being included in the category identified by the department of medicaid as covered families and children or being included in the expansion eligibility group.
(4) The participant becomes a ward of the state.
(5) The participant ceases to be eligible for medicaid.
(6) The participant exhausts the annual or lifetime payout limit specified in division (D) of section 5166.401 of the Revised Code.
(7) The participant requests that the participant's participation be terminated.
(B) A healthy Ohio program participant who ceases to participate in the program under division (A)(1) or (2) of this section may not resume participation until the former participant pays the full amount of the monthly installment payment or submits the documentation needed for the former participant's medicaid eligibility redetermination. The former participant shall not be transferred to the fee-for-service component of medicaid or the care management system as a result of ceasing to participate in the healthy Ohio program under division (A)(1) or (2) of this section.
(C) Except as provided in section 5166.407 of the Revised Code, a healthy Ohio program participant who ceases to participate in the program shall be provided the contributions that are in the participant's buckeye account at the time the participant ceases participation.

Structure Ohio Revised Code

Ohio Revised Code

Title 51 | Public Welfare

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 5166.041 | Provision of Nursing Services in a Group Visit Under a Home and Community-Based Services Medicaid Waiver Component.

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 5166.09 | Reservation of Participant Capacity for Individuals Related to Active Duty Military Who Were Receiving Services in Another State.

Section 5166.10 | Transfer of Enrollee in One Medicaid Waiver Component to Another.

Section 5166.11 | Creation of Medicaid Waiver Components for Home and Community-Based Services Programs.

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 5166.141 | Home First Component for Unified Long-Term Services and Support Medicaid Waiver Program.

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 5166.23 | Rules Regarding Payments for Home and Community-Based Services Provided Under Medicaid Component.

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 5166.309 | Practice of Nursing as Registered Nurse or Licensed Practical Nurse Not Allowed by Home Care Attendants.

Section 5166.3010 | Authorized Representative.

Section 5166.32 | Medicaid Waiver for Individuals With Cystic Fibrosis.

Section 5166.37 | Medicaid Waiver - Additional Eligibility Requirements for Members of Expansion Group.

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.

Section 5166.409 | Rules.