Ohio Administrative Code › Title 5160 - Ohio Department of Medicaid › Chapter 5160-71 - Hearings for recovery of overpayments › Section 5160-71-01 - Chapter 119. hearings conducted under authority of section 5111.914 of the Revised Code: definitions and scope of applicability

Current through all regulations passed and filed through July 1, 2024
(A) The following
			 definitions apply to Chapter 5101:6-51 of the Administrative Code.
(1) "Affected party" means a person whose
			 interests are subject to an adjudication by the Ohio department of job and
			 family services (ODJFS) under authority of section
			 5111.914 of the Revised Code.
(2) "Appellant" means an affected
			 party who has requested an adjudication hearing pursuant to Chapter 119. of the
			 Revised Code.
(3) "Department"
			 means ODJFS.
(4) "Depository
			 agent" means the official mailing address of the office of legal
			 and acquisition services of ODJFS for the purpose
			 of receiving correspondence or filings for any hearing held under authority of
			 section 5111.914 of the Revised Code.
(5) "Director" means the director
			 of ODJFS or the director's designee.
(6) "Hearing" means a hearing held by an
			 issuing state agency under authority of section
			 5111.914 of the Revised Code and
			 that is in compliance with sections
			 119.06 to
			 119.13 of the Revised Code.
(7) "Issuing state agency" means a
			 state agency that has entered into a contract with ODJFS under section
			 5111.91 of the Revised Code and
			 that has issued a notice of overpayment under authority of section
			 5111.914 of the Revised Code.
			 This shall not include a political subdivision directly or by contract.
(8) "ODJFS" means the Ohio
			 department of job and family services.
(9) "Order" means an adjudication issued by
			 ODJFS of the facts and/or sums in controversy in any hearing conducted by an
			 issuing state agency under the authority of section
			 5111.914 of the Revised Code
			 that is a final disposition of the director as regard to the rights, duties,
			 privileges, benefits, legal relationships, jurisdictional status, or standing
			 of any appellant of a proceeding initiated under authority of section
			 5111.914 of the Revised Code.
(10) "Person" means a person,
			 firm, corporation, association, or partnership.
(11) "Provider" means any person, institution
			 or entity, governmental or non-governmental, that furnishes medicaid services
			 under a provider agreement with ODJFS pursuant to Title XIX of the Social
			 Security Act, 79 Stat. 286 (1965), 
										42 U.S.C.
			 1396
									, as amended.
(12) "Provider agreement" means a contract
			 between ODJFS and a provider of medical services and supplies pursuant to rules
			 contained in Chapter 5101:3-1 of the Administrative Code.
(13) "Repayment due date" means the date that
			 payment is due to the state based upon notification of an identified
			 overpayment. The repayment due date shall be established as follows:
(a) If a settlement is reached in accordance
			 with section 5111.914 of the Revised Code,
			 the repayment shall be due no later than the forty-fifth day after full
			 execution of the settlement. A settlement is fully executed only after all
			 parties to the settlement have signed the settlement and ODJFS has issued
			 written approval of the settlement either by signing the settlement or by
			 separate written approval.
(b) If
			 settlement is not reached in accordance with section
			 5111.914 of the Revised Code,
			 the repayment shall be due within forty-five days after the effective date of
			 the adjudication order.