Ohio Administrative Code|Rule 5101:2-16-11 | Provider improper payments or misuse of publicly funded child care benefits.

                                                
(A) What is a provider improper child
		  care payment?
A provider improper child care payment means that
		  a payment was made to a provider for which the provider was not eligible to
		  receive. Improper payments are the result of one of the following:
(1) An error on the part
			 of the provider.
(2) An error on the part
			 of the county agency or the Ohio department of job and family services
			 (ODJFS).
(B) What is considered provider misuse of
		  publicly funded child care benefits or the automated child care
		  system?
Provider misuse includes, but is not limited
		  to:
(1) Utilizing the
			 personal identification information of a caretaker or designee/sponsor to log a
			 child's attendance in the automated child care system.
(2) Falsifying attendance
			 records.
(3) Knowingly seeking
			 and/or accepting payment for child care services that were not
			 provided.
(4) Knowingly seeking
			 and/or accepting payment for child care services which the provider was not
			 eligible to receive, including providing care at an unlicensed
			 location.
(5) Knowingly seeking
			 and/or accepting payment for child care services provided to a child that
			 resides in the provider's own home.
(C) What are the procedures if a provider
		  improper child care payment is a result of a county error?
If the improper payment is the result of a county
		  data error, the county agency shall:
(1) Correct the error in
			 the child care information data system.
(2) Calculate the total
			 overpayment amount that resulted from the county error.
(3) Send a provider with
			 a current provider agreement a notice of the determined overpayment using the
			 JFS 01172 "County Agency Notice of Child Care Improper Payment and
			 Repayment Requirements for Child Care Providers" (rev.
			 12/2018).
(4) Notify ODJFS of the
			 provider improper child care payment so that ODJFS may adjust all impacted
			 payments in the child care automated system.
(5) Refer all provider
			 improper child care payments for providers without a current provider agreement
			 to ODJFS.
(D) What are the repayment procedures for
		  all improper payments, including misuse of the automated child care
		  system?
(1) ODJFS may recoup one
			 hundred per cent of the over payment via payment adjustments if the provider
			 has a current provider agreement and is currently receiving payments for
			 publicly funded child care services.
(2) An invoice will be
			 issued to the provider if either of the following are true:
(a) The provider does not have a current provider agreement
				or is not currently receiving payments for publicly funded child care
				services.
(b) Overpayments are unable to be recouped through the
				payment adjustment process, for those providers currently receiving payments
				for publicly funded child care services.
(3) After thirty calendar
			 days, any remaining balance will be certified to the office of the attorney
			 general for collection.
(E) Can a child care provider request a
		  review of an identified overpayment?
(1) A child care provider
			 may request in writing to ODJFS that a reconsideration review be conducted for
			 any identified overpayment that is subject to recoupment.
(2) The written request
			 must be received by ODJFS no later than fifteen calendar days after the date
			 the provider receives the overpayment notice.
(F) What is provider fraud?
(1) Provider fraud is the
			 willful withholding or falsification of information by the provider with an
			 intent to deceive or defraud, resulting in the acceptance of or the receipt of
			 payment for which the provider was not entitled, as determined by a court of
			 law or the provider's admission.
(2) The county agency
			 shall recommend to ODJFS the termination of the provider agreement if a
			 provider has admitted or pleaded guilty to committing fraud or has been
			 convicted of fraud, as determined by a court of law.