Ohio Code 5162.365 – Responsibility for repaying overpayments
(A) A qualified medicaid school provider is solely responsible for timely repaying any overpayment that the provider receives under the medicaid school component of the medicaid program and that is discovered by a federal or state audit. This is the case regardless of whether the audit’s finding identifies the provider, department of medicaid, or department of education and workforce as being responsible for the overpayment.
Terms Used In Ohio Code 5162.365
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- Qualified medicaid school provider: means the board of education of a city, local, or exempted village school district, the governing board of an educational service center, the governing authority of a community school established under Chapter 3314 of the Revised Code, and Ohio deaf and blind education services to which both of the following apply:
(a) It holds a valid provider agreement. See Ohio Code 5162.01
- state: means the state of Ohio. See Ohio Code 1.59
(B) The department of medicaid shall not do any of the following regarding an overpayment for which a qualified medicaid school provider is responsible for repaying:
(1) Make a payment to the federal government to meet or delay the provider’s repayment obligation;
(2) Assume the provider’s repayment obligation;
(3) Forgive the provider’s repayment obligation.
(C) Each qualified medicaid school provider shall indemnify and hold harmless the department of medicaid for any cost or penalty resulting from a federal or state audit finding that a claim submitted by the provider under section 5162.361 of the Revised Code did not comply with a federal or state requirement applicable to the claim, including a requirement of a medicaid waiver component.
Last updated September 21, 2023 at 9:17 AM