Ohio Revised Code
Chapter 5168 | Hospital Care Assurance Program; Health Care Franchise Permit Fees
Section 5168.14 | Providing Basic, Medically Necessary Hospital-Level Services to Individuals Who Are Residents.

Effective: December 31, 2017
Latest Legislation: House Bill 49 - 132nd General Assembly
(A) Each hospital that receives funds distributed under sections 5168.01 to 5168.14 of the Revised Code shall provide, without charge to the individual, basic, medically necessary hospital-level services to individuals who are residents of this state, are not medicaid recipients, and whose income is at or below the federal poverty line. The medicaid director shall adopt rules under section 5168.02 of the Revised Code specifying the hospital services to be provided under this section.
(B) Nothing in this section shall be construed to prevent a hospital from requiring an individual to apply for the medicaid program before the hospital processes an application under this section. Hospitals may bill any third-party payer for services rendered under this section. Hospitals may bill the medicaid program, in accordance with state statutes governing the medicaid program and rules adopted under those statutes, for medicaid services rendered under this section if the individual becomes a medicaid recipient. Hospitals may bill individuals for services under this section if all of the following apply:
(1) The hospital has an established post-billing procedure for determining the individual's income and canceling the charges if the individual is found to qualify for services under this section.
(2) The initial bill, and at least the first follow-up bill, is accompanied by a written statement that does all of the following:
(a) Explains that individuals with income at or below the federal poverty line are eligible for services without charge;
(b) Specifies the federal poverty line for individuals and families of various sizes at the time the bill is sent;
(c) Describes the procedure required by division (C)(1) of this section.
(3) The hospital complies with any additional rules adopted under section 5168.02 of the Revised Code.
Notwithstanding division (B) of this section, a hospital providing care to an individual under this section is subrogated to the rights of any individual to receive compensation or benefits from any person or governmental entity for the hospital goods and services rendered.
(C) Each hospital shall collect and report to the department of medicaid, in the form and manner prescribed by the department, information on the number and identity of patients served pursuant to this section.
(D) This section applies beginning May 22, 1992, regardless of whether rules specifying the services to be provided have been adopted. Nothing in this section alters the scope or limits the obligation of any governmental entity or program, including the program awarding reparations to victims of crime under sections 2743.51 to 2743.72 of the Revised Code and the program for medically handicapped children established under section 3701.023 of the Revised Code, to pay for hospital services in accordance with state or local law.

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