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S. B. No. 103 As IntroducedAs Introduced
|126th General Assembly|
Senators Hagan, Dann, Fedor
To amend sections 5111.013 and 5112.17 and to enact sections 5101.56 and 5101.561 of the Revised Code to require applicants for CHIP, Disability Medical Assistance, and Medicaid to provide information about their employers, to require hospitals to gather employer information from patients who receive treatment under the Hospital Care Assurance Program, and to require an annual report identifying the employers.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 5111.013 and 5112.17 be amended and sections 5101.56 and 5101.561 of the Revised Code be enacted to read as follows:
Sec. 5101.56. (A) As used in this section and section 5101.561 of the Revised Code:
(1) "CHIP" means the children's health insurance program parts I and II provided for by sections 5101.50 to 5101.5110 of the Revised Code.
(2) "Disability medical assistance" means the program established under section 5115.10 of the Revised Code.
(3) "Employer" has the same meaning as in section 3911.091 of the Revised Code.
(4) "Medicaid" means the program provided for under Title XIX of the "Social Security Act," 79 Stat. 286 (1965), 42 U.S.C. 1396, as amended.
(B) Application forms for the CHIP, disability medical assistance, and medicaid programs shall provide for the applicant to specify the name and address of each of the applicant's employers and the name and address of each of the employers of all individuals whose income is counted in determining the applicant's eligibility for CHIP, disability medical assistance, or medicaid.
Sec. 5101.561. (A) Not later than the first day of each February, the director of job and family services shall complete a report that provides all of the following:
(1) The name and address of each employer that employed twenty-five or more employees who were any of the following while employed by the employer in this state during the previous calendar year:
(a) A recipient of CHIP, disability medical assistance, or medicaid;
(b) An individual whose income was counted in determining eligibility for CHIP, disability medical assistance, or medicaid;
(c) An individual who received hospital-level services provided without charge to the individual under section 5112.17 of the Revised Code.
(2) The total number of individuals specified in division (A)(1) of this section who were employed in the previous calendar year by the employers named in the report, broken down by employer;
(3) The total cost to the state for the previous calendar year of providing benefits under CHIP, disability medical assistance, and medicaid to employees of the employers named in the report, broken down by employer;
(4) The total cost to hospitals for the previous calendar year of providing hospital-level services without charge under section 5112.17 of the Revised Code to the employees of the employers named in the report, broken down by employer.
(B) The report shall not include any identifying information about any of the employees specified in division (A)(1) of this section.
The director shall provide a copy of the report to each member of the general assembly.
The report is a public record under section 149.43 of the Revised Code.
Sec. 5111.013. (A) The provision of medical assistance to
pregnant women and young children who are eligible for medical
assistance under division (A)(3) of section 5111.01 of the
Revised Code, but who are not otherwise eligible for medical
assistance under that section, shall be known as the healthy
(B) The department of job and family services shall do all of the
following with regard to the application procedures for the
healthy start program:
(1) Establish a short application form for the program that requires the
applicant to provide no more
information than is necessary for making determinations of
eligibility for the healthy start
program, except that the form may require applicants to provide
their social security numbers and shall comply with section 5101.56 of the Revised Code. The form shall include a
statement, which must be signed by the applicant, indicating that
she does not choose at the time of making application for the
program to apply for assistance provided under any other program
administered by the department and that she understands that she
is permitted at any other time to apply at the county department of
job and family services of the county in which she resides
other assistance administered by the department.
(2) To the extent permitted by federal law, do one or both
of the following:
(a) Distribute the application form for the program to
each public or private entity that serves as a women, infants,
and children clinic or as a child and family health clinic and to
each administrative body for such clinics and train employees of
each such agency or entity to provide applicants assistance in
completing the form;
(b) In cooperation with the department of health, develop
arrangements under which employees of county departments of
job and family services
are stationed at public or private agencies or entities
selected by the department of job and family services that
serve as women,
infants, and children clinics; child and family health clinics;
or administrative bodies for such clinics for the purpose both of
assisting applicants for the program in completing the
application form and of making determinations at that location of
eligibility for the program.
(3) Establish performance standards by which a county department of
job and family services' level of enrollment of persons
potentially eligible for the program
can be measured, and
establish acceptable levels of enrollment for each county department.
(4) Direct any county department of job and family
rate of enrollment of potentially eligible enrollees in
program is below acceptable levels established under division
(B)(3) of this section to implement corrective action. Corrective action may
include but is not limited to any one or more of the following to
the extent permitted by federal law:
(a) Establishing formal referral and outreach methods with
local health departments and local entities receiving funding
through the bureau of maternal and child health;
(b) Designating a specialized intake unit within the
for healthy start applicants;
(c) Establishing abbreviated timeliness requirements to
shorten the time between receipt of an application and the
scheduling of an initial application interview;
(d) Establishing a system for telephone scheduling of
intake interviews for applicants;
(e) Establishing procedures to minimize the time an
applicant must spend in completing the application and
eligibility determination process, including permitting
applicants to complete the process at times other than the
regular business hours of the county department
and at locations other than the offices of the county
(C) To the extent permitted by federal law, local funds,
whether from public or private sources, expended by a county
for administration of the healthy start program shall be considered to
expended by the state for the purpose of determining the extent
to which the state has complied with any federal requirement that
the state provide funds to match federal funds for medical
assistance, except that this division shall not affect the amount
of funds the county is entitled to
receive under section 5101.16, 5101.161, or
5111.012 of the Revised
(D) The director of job and family services shall do one or both of
(1) To the extent that federal funds are provided for such
assistance, adopt a plan for granting presumptive eligibility for
pregnant women applying for healthy start;
(2) To the extent permitted by federal medicaid
regulations, adopt a plan for making same-day determinations of
eligibility for pregnant women applying for healthy start.
(E) A county department of job and family services
that maintains offices at more
than one location shall accept applications for the healthy start program
at all of those locations.
(F) The director of job and family services shall adopt
accordance with section 111.15 of the Revised Code as necessary
to implement this section.
Sec. 5112.17. (A) As used in this section:
(1) "Federal poverty guideline" means the official poverty
guideline as revised annually by the United States secretary of
health and human services in accordance with section 673 of the
"Community Service Block Grant Act," 95 Stat. 511 (1981), 42
U.S.C.A. 9902, as amended, for a family size equal to the size of
the family of the person whose income is being determined.
(2) "Third-party payer" means any private or public entity
or program that may be liable by law or contract to make payment
to or on behalf of an individual for health care services.
"Third-party payer" does not include a hospital.
(B) Each hospital that receives funds distributed
under sections 5112.01 to 5112.21 of
the Revised Code shall provide, without charge to the individual, basic,
medically necessary hospital-level services to individuals who
are residents of this state, are not recipients of the medical
assistance program, and whose income is at or
below the federal
Recipients of disability financial
assistance and recipients of disability medical assistance provided under Chapter 5115. of the Revised Code qualify for
services under this section. The director of
job and family services
shall adopt rules under section 5112.03 of the Revised Code
specifying the hospital services to be provided under this
(C) Nothing in this section shall
be construed to prevent a hospital from requiring an individual to apply for
eligibility under the medical assistance program before the hospital processes
an application under this section. Hospitals may bill any
payer for services
rendered under this section. Hospitals may bill the medical
assistance program, in accordance with Chapter 5111. of the
Revised Code and the rules adopted under that chapter, for
services rendered under this section if the individual becomes a
recipient of the program. Hospitals may bill individuals for
services under this section if all of the following apply:
(1) The hospital has an established post-billing procedure
for determining the individual's income and canceling the charges
if the individual is found to qualify for services under this
(2) The initial bill, and at least the first follow-up
bill, is accompanied by a written statement that does all of the
(a) Explains that individuals with income at or below the
federal poverty guideline are eligible for services without
(b) Specifies the federal poverty guideline for
individuals and families of various sizes at the time the bill is
(c) Describes the procedure required by division (C)(1) of
(3) The hospital complies with any additional rules the
department adopts under section 5112.03 of the Revised Code.
Notwithstanding division (B) of this section, a hospital
providing care to an individual under this section is subrogated
to the rights of any individual to receive compensation or
benefits from any person or governmental entity for the hospital
goods and services rendered.
(D) Each hospital shall collect and report to the
department, in the form and manner prescribed by the department,
the both of the following:
(1) The number and identity of patients served
pursuant to this section;
(2) Any other information the department needs to complete the report required by section 5101.561 of the Revised Code.
(E) This section applies beginning May 22, 1992,
regardless of whether the department has adopted rules specifying
the services to be provided. Nothing in this section alters the
scope or limits the obligation of any governmental entity or
program, including the program awarding reparations to victims of
crime under sections 2743.51 to 2743.72 of the Revised Code and
program for medically handicapped children established under
section 3701.023 of the Revised Code, to pay for hospital services in
accordance with state or local law.
Section 2. That existing sections 5111.013 and 5112.17 of the Revised Code are hereby repealed.