5111.68 [Effective Until 8/31/2010] Overpayment amounts determined following notice of closure, etc.
(A) On receipt of a written notice under section 5111.66 of the Revised Code of a facility closure, voluntary termination, or voluntary withdrawal of participation or a written notice under section 5111.67 of the Revised Code of a change of operator, the department of job and family services shall determine the amount of any overpayments made under the medicaid program to the exiting operator, including overpayments the exiting operator disputes, and other actual and potential debts the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program. In determining the exiting operator’s other actual and potential debts to the department under the medicaid program, the department shall include all of the following that the department determines is applicable:
(1) Refunds due the department under section 5111.27 of the Revised Code;
(2) Interest owed to the department and United States centers for medicare and medicaid services;
(3) Final civil monetary and other penalties for which all right of appeal has been exhausted;
(4) Money owed the department and United States centers for medicare and medicaid services from any outstanding final fiscal audit, including a final fiscal audit for the last fiscal year or portion thereof in which the exiting operator participated in the medicaid program.
(B) If the department is unable to determine the amount of the overpayments and other debts for any period before the effective date of the entering operator’s provider agreement or the effective date of the facility closure, voluntary termination, or voluntary withdrawal of participation, the department shall make a reasonable estimate of the overpayments and other debts for the period. The department shall make the estimate using information available to the department, including prior determinations of overpayments and other debts.
Amended by 128th General Assembly File No. 9, HB 1, (Vetoed Provisions) §101.01, eff. 10/16/2009.
Effective Date: 07-01-2005
This section is set out twice. See also § 5111.68, as amended by 128th General Assembly File No. 33, HB 398, § 1, eff. 8/31/2010.
5111.68 [Effective 8/31/2010] Overpayment amounts determined following notice of closure, etc
(A) On receipt of a written notice under section 5111.66 of the Revised Code of a facility closure, voluntary termination, or voluntary withdrawal of participation or a written notice under section 5111.67 of the Revised Code of a change of operator, the department of job and family services shall estimate the amount of any overpayments made under the medicaid program to the exiting operator, including overpayments the exiting operator disputes, and other actual and potential debts the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program, including a franchise permit fee.
(B) In estimating the exiting operator’s other actual and potential debts to the department and the United States centers for medicare and medicaid services under the medicaid program, the department shall use a debt estimation methodology the director of job and family services shall establish in rules adopted under section 5111.689 of the Revised Code. The methodology shall provide for estimating all of the following that the department determines are applicable:
(1) Refunds due the department under section 5111.27 of the Revised Code;
(2) Interest owed to the department and United States centers for medicare and medicaid services;
(3) Final civil monetary and other penalties for which all right of appeal has been exhausted;
(4) Money owed the department and United States centers for medicare and medicaid services from any outstanding final fiscal audit, including a final fiscal audit for the last fiscal year or portion thereof in which the exiting operator participated in the medicaid program;
(5) Other amounts the department determines are applicable.
(C) The department shall provide the exiting operator written notice of the department’s estimate under division (A) of this section not later than thirty days after the department receives the notice under section 5111.66 of the Revised Code of the facility closure, voluntary termination, or voluntary withdrawal of participation or the notice under section 5111.67 of the Revised Code of the change of operator. The department’s written notice shall include the basis for the estimate.
Amended by 128th General Assembly File No. 33, HB 398, § 1, eff. 8/31/2010.
Amended by 128th General Assembly File No. 9, HB 1, (Vetoed Provisions) §101.01, eff. 10/16/2009.
Effective Date: 07-01-2005
This section is set out twice. See also § 5111.68, effective until 8/31/2010.
5111.68 [Effective Until 8/31/2010] Overpayment amounts determined following notice of closure, etc.
(A) On receipt of a written notice under section 5111.66 of the Revised Code of a facility closure, voluntary termination, or voluntary withdrawal of participation or a written notice under section 5111.67 of the Revised Code of a change of operator, the department of job and family services shall determine the amount of any overpayments made under the medicaid program to the exiting operator, including overpayments the exiting operator disputes, and other actual and potential debts the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program. In determining the exiting operator’s other actual and potential debts to the department under the medicaid program, the department shall include all of the following that the department determines is applicable:
(1) Refunds due the department under section 5111.27 of the Revised Code;
(2) Interest owed to the department and United States centers for medicare and medicaid services;
(3) Final civil monetary and other penalties for which all right of appeal has been exhausted;
(4) Money owed the department and United States centers for medicare and medicaid services from any outstanding final fiscal audit, including a final fiscal audit for the last fiscal year or portion thereof in which the exiting operator participated in the medicaid program.
(B) If the department is unable to determine the amount of the overpayments and other debts for any period before the effective date of the entering operator’s provider agreement or the effective date of the facility closure, voluntary termination, or voluntary withdrawal of participation, the department shall make a reasonable estimate of the overpayments and other debts for the period. The department shall make the estimate using information available to the department, including prior determinations of overpayments and other debts.
Amended by 128th General Assembly File No. 9, HB 1, (Vetoed Provisions) §101.01, eff. 10/16/2009.
Effective Date: 07-01-2005
This section is set out twice. See also § 5111.68, as amended by 128th General Assembly File No. 33, HB 398, § 1, eff. 8/31/2010.
5111.68 [Effective 8/31/2010] Overpayment amounts determined following notice of closure, etc
(A) On receipt of a written notice under section 5111.66 of the Revised Code of a facility closure, voluntary termination, or voluntary withdrawal of participation or a written notice under section 5111.67 of the Revised Code of a change of operator, the department of job and family services shall estimate the amount of any overpayments made under the medicaid program to the exiting operator, including overpayments the exiting operator disputes, and other actual and potential debts the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program, including a franchise permit fee.
(B) In estimating the exiting operator’s other actual and potential debts to the department and the United States centers for medicare and medicaid services under the medicaid program, the department shall use a debt estimation methodology the director of job and family services shall establish in rules adopted under section 5111.689 of the Revised Code. The methodology shall provide for estimating all of the following that the department determines are applicable:
(1) Refunds due the department under section 5111.27 of the Revised Code;
(2) Interest owed to the department and United States centers for medicare and medicaid services;
(3) Final civil monetary and other penalties for which all right of appeal has been exhausted;
(4) Money owed the department and United States centers for medicare and medicaid services from any outstanding final fiscal audit, including a final fiscal audit for the last fiscal year or portion thereof in which the exiting operator participated in the medicaid program;
(5) Other amounts the department determines are applicable.
(C) The department shall provide the exiting operator written notice of the department’s estimate under division (A) of this section not later than thirty days after the department receives the notice under section 5111.66 of the Revised Code of the facility closure, voluntary termination, or voluntary withdrawal of participation or the notice under section 5111.67 of the Revised Code of the change of operator. The department’s written notice shall include the basis for the estimate.
Amended by 128th General Assembly File No. 33, HB 398, § 1, eff. 8/31/2010.
Amended by 128th General Assembly File No. 9, HB 1, (Vetoed Provisions) §101.01, eff. 10/16/2009.
Effective Date: 07-01-2005
This section is set out twice. See also § 5111.68, effective until 8/31/2010.
5111.68 [Effective Until 8/31/2010] Overpayment amounts determined following notice of closure, etc.
(A) On receipt of a written notice under section 5111.66 of the Revised Code of a facility closure, voluntary termination, or voluntary withdrawal of participation or a written notice under section 5111.67 of the Revised Code of a change of operator, the department of job and family services shall determine the amount of any overpayments made under the medicaid program to the exiting operator, including overpayments the exiting operator disputes, and other actual and potential debts the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program. In determining the exiting operator’s other actual and potential debts to the department under the medicaid program, the department shall include all of the following that the department determines is applicable:
(1) Refunds due the department under section 5111.27 of the Revised Code;
(2) Interest owed to the department and United States centers for medicare and medicaid services;
(3) Final civil monetary and other penalties for which all right of appeal has been exhausted;
(4) Money owed the department and United States centers for medicare and medicaid services from any outstanding final fiscal audit, including a final fiscal audit for the last fiscal year or portion thereof in which the exiting operator participated in the medicaid program.
(B) If the department is unable to determine the amount of the overpayments and other debts for any period before the effective date of the entering operator’s provider agreement or the effective date of the facility closure, voluntary termination, or voluntary withdrawal of participation, the department shall make a reasonable estimate of the overpayments and other debts for the period. The department shall make the estimate using information available to the department, including prior determinations of overpayments and other debts.
Amended by 128th General Assembly File No. 9, HB 1, (Vetoed Provisions) §101.01, eff. 10/16/2009.
Effective Date: 07-01-2005
This section is set out twice. See also § 5111.68, as amended by 128th General Assembly File No. 33, HB 398, § 1, eff. 8/31/2010.
5111.68 [Effective 8/31/2010] Overpayment amounts determined following notice of closure, etc
(A) On receipt of a written notice under section 5111.66 of the Revised Code of a facility closure, voluntary termination, or voluntary withdrawal of participation or a written notice under section 5111.67 of the Revised Code of a change of operator, the department of job and family services shall estimate the amount of any overpayments made under the medicaid program to the exiting operator, including overpayments the exiting operator disputes, and other actual and potential debts the exiting operator owes or may owe to the department and United States centers for medicare and medicaid services under the medicaid program, including a franchise permit fee.
(B) In estimating the exiting operator’s other actual and potential debts to the department and the United States centers for medicare and medicaid services under the medicaid program, the department shall use a debt estimation methodology the director of job and family services shall establish in rules adopted under section 5111.689 of the Revised Code. The methodology shall provide for estimating all of the following that the department determines are applicable:
(1) Refunds due the department under section 5111.27 of the Revised Code;
(2) Interest owed to the department and United States centers for medicare and medicaid services;
(3) Final civil monetary and other penalties for which all right of appeal has been exhausted;
(4) Money owed the department and United States centers for medicare and medicaid services from any outstanding final fiscal audit, including a final fiscal audit for the last fiscal year or portion thereof in which the exiting operator participated in the medicaid program;
(5) Other amounts the department determines are applicable.
(C) The department shall provide the exiting operator written notice of the department’s estimate under division (A) of this section not later than thirty days after the department receives the notice under section 5111.66 of the Revised Code of the facility closure, voluntary termination, or voluntary withdrawal of participation or the notice under section 5111.67 of the Revised Code of the change of operator. The department’s written notice shall include the basis for the estimate.
Amended by 128th General Assembly File No. 33, HB 398, § 1, eff. 8/31/2010.
Amended by 128th General Assembly File No. 9, HB 1, (Vetoed Provisions) §101.01, eff. 10/16/2009.
Effective Date: 07-01-2005
This section is set out twice. See also § 5111.68, effective until 8/31/2010.
