Ohio Code 5160.291 – Changes affecting eligibility
(A)(1) As information described in division (A) of section 5160.29 of the Revised Code is received by the department of medicaid or an entity with which the department has entered into an agreement under section 5160.30 of the Revised Code, the department or entity shall do both of the following on at least a quarterly basis and in accordance with federal regulations:
Terms Used In Ohio Code 5160.291
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Medical assistance program: means all of the following:
(1) The medicaid program;
(2) The children's health insurance program;
(3) The refugee medical assistance program;
(4) Any other program that provides medical assistance and state statutes authorize the department of medicaid to administer. See Ohio Code 5160.01
- medical assistance recipient: includes an individual applying for a medical assistance program, a former medical assistance recipient, or both. See Ohio Code 5160.01
(a) Review the information to determine whether it indicates a change in circumstances that may affect eligibility for a medical assistance program;
(b) Take appropriate action.
( 2) Division (A)(1) of this section applies only to the extent information described in division (A) of section 5160.29 of the Revised Code is available to the department or entity.
(B) If the department of medicaid or an entity with which the department has entered into an agreement under section 5160.30 of the Revised Code receives information concerning a medical assistance recipient that indicates a change in circumstances that may affect the recipient’s continued eligibility for the medical assistance program in which the recipient is enrolled, the department or entity shall take appropriate action, including verifying unclear information, providing prior written notice of a change or adverse action, and notifying the recipient of the right to appeal under section 5160.31 of the Revised Code.