Ohio Admin. Code 5101:12-1-56 - Assigned medical support collections incentives

(A) The following definitions apply to this rule:

(1) "Assigned medical support" means the medicaid applicant, recipient, or participant has assigned the right to collect and retain medical support from an obligor or medical reimbursement from a third party to the Ohio department of job and family services (ODJFS).

(2) "Third party" means any private medical insurer, individual, entity, or public or private medical program that is or may be liable to pay all or part of the cost of injury, disease, or disability on behalf of a medicaid applicant, recipient, or participant.

(B) When the child support enforcement agency (CSEA) is made aware of an accident or injury involving the medicaid applicant, recipient, or participant, the CSEA shall complete the ODM 06613, "Accident/Injury Insurance Information" (effective or revised effective date as identified in rule 5101:12-1-99 of the Administrative Code), send it to the Ohio department of medicaid (ODM), and send a copy to the county department of job and family services (CDJFS).

(C) When assigned medical support and assigned third party collections are received:

(1) The CSEA is entitled to have fifteen per cent of the total collection; and

(2) ODJFS is entitled to have eighty-five per cent of the total collection The remainder is distributed to ODM, subject to the applicable federal medical assistance percentage (FMAP) that is calculated annually by the federal government.

Notes

Ohio Admin. Code 5101:12-1-56

Effective: 6/1/2021
Five Year Review (FYR) Dates: 1/28/2021 and 06/01/2026
Promulgated Under: 119.03
Statutory Authority: 3125.25
Rule Amplifies: 3125.03, 3125.25
Prior Effective Dates: 01/07/1985, 08/01/1986, 12/01/1987, 12/20/1988, 09/01/1989, 08/01/1990, 06/01/1991, 11/01/1991, 07/15/1992, 04/01/1993, 01/01/1998, 12/20/1998, 07/01/2002, 10/02/2003, 01/01/2007, 05/01/2012, 06/01/2015