Ohio Administrative Code|Rule 5160:1-2-01 | Medicaid: administrative agency responsibilities.

                                                
(A) This rule describes the
		  responsibilities of the administrative agency.
(B) Calculation of time periods for eligibility determinations.
		  All calculations of time periods used in the determination of eligibility,
		  including an annual renewal or a redetermination as a result of a reported
		  change, shall be computed as follows:
(1) When counting the
			 number of days in a specified time period, the initial day is excluded from the
			 computation and the last day is included.
(2) When the last day of
			 the time period falls on a Saturday, Sunday, or legal holiday, the time period
			 shall end on the next business day.
(C) Effective date of applications,
		  reported information, or requests for applications or assistance. Applications,
		  documents, or information submitted or provided to the administrative agency,
		  or requests made to the administrative agency, are considered received by the
		  administrative agency:
(1) That day, when
			 received by the administrative agency or the electronic eligibility system
			 during the administrative agency's business hours.
(2) On the next business
			 day, when received by the administrative agency or the electronic eligibility
			 system after the administrative agency's business hours or on a
			 non-business day when the administrative agency is closed.
(D) Request for application. When an
		  individual requests an application, the administrative agency
		  shall:
(1) Not deny an
			 individual's right to apply or discourage an individual from
			 applying.
(2) Inform the individual
			 of the following:
(a) An online application portal is available to complete an
				application for medical assistance and application assistance is available
				through the portal.
(b) The beginning date of benefits depends on the date the signed
				application is received by the administrative agency. 
(c) The verification requirements and deadlines.
(d)  Individuals shall cooperate with eligibility determinations,
				renewals, redeterminations, audits, and quality control processes as defined in
				this chapter of the Administrative Code.
(e) The meaning of and penalties for medicaid eligibility fraud
				as set forth in section 2913.401 of the Revised Code.
(f) The Ohio attorney general (AGO) shall seek recovery or
				adjustment on behalf of the administrative agency from the estate of the
				following individuals, as set forth in rule 5160:1-2-07 of the Administrative
				Code:
(i) A permanently
				  institutionalized individual of any age; or
(ii) An individual
				  fifty-five years of age or older who is not permanently
				  institutionalized.
(3) Fulfill a request for
			 an application within one business day.
(a) Fulfillment occurs when the administrative agency sends an
				electronic copy of the application or a link to an electronic copy of the
				application to the text or email address provided by the individual; hands the
				application to the individual; or places the application in the U.S. mail. When
				the application is provided in person or via U.S. mail, the administrative
				agency shall enclose a preaddressed, postage-paid envelope for return of the
				application.
(b) The application shall be accompanied by the JFS 07217
				"Voter Registration Notice of Rights and Declination" (rev. 8/2009),
				or a notice meeting the requirements of section 3503.10 of the Revised Code,
				and a voter registration form as required by section 329.051 of the Revised
				Code.
(E) Upon receipt of a request for
		  assistance or receipt of an application, the administrative agency
		  shall:
(1) Make program
			 information available and accessible to an individual upon request, consistent
			 with 42 C.F.R. 435.905 (as in effect October 1, 2019):
(a) Provide language services at no cost to an individual
				with limited English proficiency, including oral interpretation and written
				translations; and
(b) Provide auxiliary aids and services at no cost to an
				individual living with a disability in accordance with the Americans with
				Disabilities Act of 1990 (ADA) (Pub. L. No. 101-336) and section 504 of the
				Rehabilitation Act of 1973 (Pub. L. No. 93-112).
(2) Distribute voter information and
			 registration materials as required by 42 C.F.R. 431.307 (as in effect October
			 1, 2019).
(3) Coordinate with the special
			 supplemental nutrition program for women, infants and children (WIC) as
			 required by 42 C.F.R. 431.635 (as in effect October 1, 2019) to ensure written
			 notice of the availability of the WIC program is provided to an individual
			 determined eligible for medical assistance, including an individual who is
			 presumptively eligible and is also a potential WIC recipient. 
(a) The administrative agency shall advise a potential WIC
				recipient of the WIC program and refer the individual to the WIC agency by
				forwarding a copy of the individual's medical assistance application and
				any supplemental application, unless the individual is already receiving WIC
				assistance.
(b) For an individual already in receipt of medical
				assistance who is a potential WIC recipient, the administrative agency shall
				advise the individual of the WIC program at least annually.
(c) The following individuals are potential WIC
				recipients:
(i) A woman who
				  is:
(a) Pregnant; or
(b) Within a six-month period after giving birth; or
(c) Breastfeeding her infant within twelve months after the
					 infant's birth; or
(ii) A child younger than
				  five years old.
(F) Assistance.
(1) The administrative
			 agency shall allow a person or persons of the individual's choice to
			 accompany, assist with, and represent the individual in the application,
			 redetermination, or annual renewal process.
(a) A person may accompany and assist an individual without being
				an individual's authorized representative.
(b) The administrative agency shall not reveal confidential
				information, as described in rule 5160-1-32 of the Administrative Code, or send
				notices or correspondence to the person assisting the individual, unless the
				person has been designated in writing as an authorized
				representative.
(c) A person who is assisting an individual shall provide
				accurate information, to the best of his or her knowledge, regardless of
				whether the person is an authorized representative.
(2) When an individual
			 has designated in writing an authorized representative, the administrative
			 agency shall:
(a) Issue all notices and correspondence to both the authorized
				representative and the individual.
(b) Contact the individual to clarify or verify information
				provided by an authorized representative when the information provided on the
				application seems contradictory, unclear, or unrealistic.
(c) Remove the authorized representative from any correspondence
				or access to safeguarded information upon receipt of notice that:
(i) The authorized
				  representative is declining or ending representation of the individual;
				  or
(ii) The individual has
				  withdrawn the authorized representative's authority.
(3) The administrative
			 agency shall help complete the application when assistance is needed, including
			 assistance through agents of the administrative agency, such as eligibility
			 workers.
(a) At the individual's request, an eligibility worker shall
				assist with completing the application by asking the individual for answers
				needed to complete the application, then recording the individual's
				answers on the application form or in the electronic eligibility system. The
				eligibility worker shall not alter any answers given by the
				individual.
(b) When an eligibility worker assists with or helps complete an
				application, the worker shall sign the application form and include the
				worker's title as a person who assisted with completing the
				application.
(c) The process of inputting data into the electronic eligibility
				system or determining an individual's eligibility shall not be construed
				as providing assistance.
(4) Upon request, the
			 administrative agency shall provide assistance to individuals having difficulty
			 gathering verifications.
(5) When determining
			 eligibility for an individual with a physical or mental impairment that
			 substantially limits the individual's ability to access verifications, and
			 who has not granted any person durable power of attorney, or who does not have
			 a court-appointed guardian or a person with other legal authority and
			 obligation to act on behalf of the individual, the administrative agency
			 shall:
(a) Explore whether another person is available to assist the
				individual with obtaining verifications or accessing the individual's
				means of self-support. For an individual who resides in a nursing facility
				(NF), explore whether the person who signed the NF admission contract is able
				to assist the individual.
(i) When a person is
				  available to assist the individual, request the person assist with obtaining
				  the verifications or accessing the individual's means of
				  self-support.
(ii) When verifications
				  are provided, or when means of self-support are able to be accessed by the
				  individual or on the individual's behalf by another person, the
				  administrative agency shall consider the verified criteria or means of
				  self-support in the eligibility determination process.
(b) When no person with the ability to access the
				individual's means of self-support is available to assist the
				individual:
(i) Refer the
				  individual's case to the administrative agency's legal counsel and
				  request counsel evaluate whether the matter should be referred to the probate
				  court, adult protective services, or another entity deemed by the
				  administrative agency's legal counsel to be appropriate. For cases
				  referred to counsel for such evaluation, the administrative agency shall
				  also:
(a) Note in the individual's case record that verifications
					 or means of self-support are not available and shall not be considered a
					 disqualifying factor until a means of access to those items is obtained or
					 established; and
(b) Inform the administrative agency's legal counsel of any
					 eligibility approval or denial.
(ii) Determine
				  eligibility in accordance with Chapter 5160:1-2 of the Administrative Code, but
				  without considering eligibility factors for which verification cannot be
				  obtained or means of self-support cannot be accessed because of the
				  individual's physical or mental impairment. Use the most reliable
				  information available without delaying the determination of
				  eligibility.
(iii) Redetermine
				  eligibility once a means of access to verifications or means of self-support is
				  obtained or established. When such access has not been obtained prior to the
				  individual's annual renewal, determine continuing eligibility using the
				  most reliable information available.
(G) Receipt of application. Upon receipt
		  of a signed application for medical assistance or for specific medical
		  assistance services or programs, the administrative agency shall:
(1) Give or send a
			 receipt to the individual showing the date of application.
(2) Accept and register
			 the application within one business day of the time the signed application is
			 received. Only an application signed under penalty of perjury in accordance
			 with 42 C.F.R. 435.907 (as in effect October 1, 2019) is considered
			 valid.
(a) Acceptable signatures for an application
				include:
(i) An original
				  handwritten signature; and
(ii) An "electronic signature" or
				  "e-signature," that includes electronic sounds, symbols, or processes
				  attached to or logically associated with records and executed or adopted by
				  individuals with the intent to sign a record. An electronic signature satisfies
				  legal requirements in accordance with section 1306.06 of the Revised Code and
				  includes:
(a) An audio or
					 "telephonically recorded" signature obtained in accordance with
					 procedures approved by the Ohio department of job and family services (ODJFS)
					 that is retrievable and complies with federal record retention requirements in
					 accordance with 7 C.F.R. 272.1(f) (as in effect October 1, 2019);
					 and
(b) A signature submitted
					 electronically as part of the online medical assistance application process;
					 and
(c) A handwritten
					 signature transmitted via any other electronic transmission, such as through
					 email or facsimile; and
(d) A rubber stamp that
					 replaces a signature for an individual who has an inability to sign in
					 accordance with the Rehabilitation Act of 1973 (Pub. L. No. 93-112);
					 and
(e) When the signatory
					 cannot sign with a name, an "X" is a valid signature;
					 and
(f) An electronically signed application received from the
					 federally facilitated marketplace (FFM); and
(g) An electronically
					 signed application received from the social security administration (SSA) for
					 the low-income subsidy (LIS) program.
(b) An individual who applies for health coverage through
				the FFM will be assessed for medicaid eligibility with the signature provided
				to the FFM.
(3) When an application is received from
			 a local WIC clinic, maternal, child and family health (MCFH) clinic, or the
			 children with medical handicaps program (CMH) office within five business days
			 of the signature date, the application shall be registered using the signature
			 date. If the application is not received within five business days of the
			 signature date, the application shall be registered using the date the
			 application was received by the administrative agency.
(4) When an application taken by an
			 outstationed worker assigned to a federally qualified health center (FQHC) or a
			 disproportionate share hospital (DSH) is not directly entered into the
			 electronic eligibility system, the application shall immediately be submitted
			 to the appropriate administrative agency, which shall register the application
			 using the signature date.
(5) The administrative agency shall not
			 delay the registration or processing of an application due to the lack of a
			 signed acknowledgment of an individual's rights and
			 responsibilities.
(6) As required by section 329.051 of the
			 Revised Code, the administrative agency shall:
(a) Give or send a notice meeting the requirements of
				section 3503.10 of the Revised Code or the JFS 07217 "Voter Registration
				Notice of Rights and Declination" (rev. 8/2009); and
(b) Give or send the "Voter Registration Information
				and Update Form" (undated) as prescribed by the secretary of
				state.
(H) Verifications. Where manual
		  verifications are required under rule 5160:1-2-10 of the Administrative Code,
		  the administrative agency shall:
(1) Follow the
			 safeguarding guidelines set forth in rule 5160-1-32 of the Administrative Code
			 when providing or gathering information by telephone, in person, or in
			 electronic or written form.
(2) Not require that an individual
			 provide verification of unchanged information unless the information is
			 incomplete, inaccurate, inconsistent, outdated, or missing from the case record
			 due to record retention limitations.
(3) Not request that an
			 individual provide duplicate copies of previously submitted
			 verifications.
(4) To the extent possible, verify
			 relevant eligibility criteria using electronic records available through the
			 electronic eligibility system. Where electronic verification is not available,
			 or electronic verification data conflicts with the individual's
			 attestation, request verifications as set out in rule 5160:1-2-10 of the
			 Administrative Code.
(5) When the
			 administrative agency is unable to verify eligibility criteria through
			 electronic sources, the administrative agency shall contact the applicant to
			 collect information needed to process the application. If the individual
			 declares the verifications cannot be accessed or submitted, the
			 individual's statement shall be accepted. If the administrative agency is
			 unable to make contact with the applicant, a written (electronic or on paper)
			 request for the necessary information or verification documents shall be
			 sent.
(a) The written request shall:
(i) Include the date by
				  which the information must be provided to the administrative agency;
				  and
(ii) Inform the
				  individual that any delay in providing requested information or documents will
				  delay the determination of an individual's eligibility; and
(iii) Provide information
				  regarding how an individual can request assistance from the administrative
				  agency with gathering the requested documents.
(b) When the information or verification required to establish
				the individual's eligibility for assistance is not received by the
				administrative agency by the stated date, the administrative agency shall
				contact the individual in writing no more than twenty calendar days following
				the date of the application.
(i) The follow-up request
				  for information or verification documents:
(a) Shall be sent electronically, via postal mail, or personally
					 delivered to the individual. When sent via postal mail or personally delivered,
					 the administrative agency shall enclose a preaddressed, postage paid envelope
					 for return of the verification(s); and
(b) Shall state that the required information or verification has
					 not been received and that if the information or verification is not received
					 within ten calendar days the administrative agency shall deny the application
					 for medical assistance; and
(c) Shall include a clear statement that the administrative
					 agency will assist with obtaining the required information or verification if
					 the request for assistance is received on or prior to the given deadline;
					 and
(d) Does not serve as a notice of denial of the
					 application.
(ii) When the requested
				  information or verification is not received by the stated deadline, the
				  administrative agency shall propose a denial of benefits.
(c) The administrative agency shall deny the individual's
				application when the individual fails to provide the necessary information or
				verifications, or request assistance and cooperate with obtaining
				verifications, within the time specified in the second verification request.
				When this happens:
(i) An individual may
				  reapply at any time.
(ii) An individual shall
				  not be asked to re-verify information previously verified by the administrative
				  agency without reason to believe the information may have changed.
(6) Give or send a dated itemized receipt
			 that lists each verification document received from an individual.
(7) Record receipt of all verification
			 documents, photocopy or scan the documents, and retain copies or images of the
			 documents in the case record.
(8) When information is verified through
			 a telephone contact, record the following details:
(a) The name and telephone number of the person providing the
				information; and
(b) The name of the agency or business contacted, when
				applicable; and
(c) The date of the contact; and
(d) An accurate summary of the information provided.
(I) Determination, redetermination, and
		  renewal of eligibility. The administrative agency shall:
(1) Not schedule an
			 interview except at the request of the applicant.
(2) Inform all
			 individuals at the time of application and renewal that the agency will obtain
			 and use information available from the income and eligibility verification
			 system (IEVS) to assist with the determination of eligibility, as required by
			 section 1137 of the Social Security Act (as in effect October 1,
			 2019).
(3) Require a signature
			 for all renewals of medical assistance where eligibility was not passively
			 renewed using the electronic eligibility system.
(4) Using the electronic eligibility
			 system, the administrative agency shall:
(a) Determine eligibility or renewal of an individual's
				eligibility for medical assistance within the application processing time
				limits set forth in this rule.
(i) The administrative
				  agency shall not approve medical assistance to an individual merely because of
				  an agency error or delay in determining eligibility. All eligibility factors
				  shall be met.
(ii) The administrative
				  agency shall not delay the approval of medical assistance due to the lack of
				  information or verifications necessary to determine eligibility for other
				  public assistance programs.
(b) Document and record determinations of eligibility. The
				administrative agency shall:
(i) Record, in physical or electronic case records, any
				  information, action, decision, or delay in the application, eligibility
				  determination, or discontinuance processes, as well as the reasons for any
				  action, decision, or delay.
(ii) Make the case
				  records, physical or electronic, available for compliance audits.
(c) Approve medical assistance for an individual
				who:
(i) Has signed an
				  application under penalty of perjury; and
(ii) Has provided all
				  necessary verifications as set forth in rule 5160:1-2-10 of the Administrative
				  Code; and
(iii) Meets all
				  conditions of eligibility for a medical assistance category set forth in
				  Chapter 5160:1-2, 5160:1-3, 5160:1-4, 5160:1-5, or 5160:1-6 of the
				  Administrative Code. When an individual who attests to U.S. citizenship or
				  qualified non-citizen status meets all conditions of eligibility for a medical
				  assistance category except for verification of the individual's
				  citizenship or qualified non-citizen status, the administrative agency shall
				  approve time-limited coverage during a reasonable opportunity period (ROP) as
				  required in rule 5160:1-2-11 or 5160:1-2-12 of the Administrative
				  Code.
(d) Deny an application for medical assistance for an individual
				who:
(i) Has not signed an
				  application under penalty of perjury; or
(ii) Withdraws the
				  application; or
(iii) Fails to cooperate
				  with the application or determination process or fails to provide all necessary
				  verifications set forth in rule 5160:1-2-10 of the Administrative Code;
				  or
(iv) Does not meet all
				  conditions of eligibility for any medical assistance category set forth in
				  Chapter 5160:1-2, 5160:1-3, 5160:1-4, 5160:1-5, or 5160:1-6 of the
				  Administrative Code.
(e) Suspend medical assistance upon notification that an
				individual meets any of the criteria for ineligibility for payment of services
				set forth in rule 5160:1-1-03 of the Administrative Code.
(f) Discontinue medical assistance for an individual
				who:
(i) Requests that
				  assistance be discontinued; or
(ii) Is no longer an Ohio
				  resident, or is deceased.
(J) Reinstatement of medical assistance
		  for individuals whose termination of medical assistance was effective prior to
		  March 18, 2020.
(1) When an individual
			 cooperates with the renewal process, the administrative agency
			 shall:
(a) Reinstate medical assistance, discontinued for failure to
				cooperate with the renewal process or verification of a reported change, within
				ninety calendar days of the discontinuance date without requiring a new
				application in accordance with 42 C.F.R. 435.916(a)(3)(C)(iii) (as in effect
				October 1, 2019).
(b) Accept the renewal form and/or verifications that caused the
				discontinuance of medical assistance.
(c) Reinstate medical assistance if all eligibility criteria are
				met.
(d) Reinstated medical assistance coverage shall begin on the
				first day of the calendar month following the month medical assistance was
				discontinued.
(2) Individuals
			 discontinued due to returned mail indicating whereabouts unknown.
(a) When the individual's whereabouts become known within
				the eligibility period, the administrative agency shall reinstate any
				discontinued medical assistance in accordance with 42 C.F.R. 431.231(d) (as in
				effect October 1, 2019).
(b) When the individual's whereabouts become known after the
				effective discontinuance date, a new application for medical assistance is
				required. 
(3) When a hearing
			 request is filed timely by an individual as outlined in division 5101:6 of the
			 Administrative Code, the administrative agency shall reinstate medical
			 assistance benefits at the same benefit level until a hearing decision is
			 rendered in accordance with 42 C.F.R. 431.230 (as in effect October 1,
			 2019).
(K) Reinstatement of medical assistance
		  for individuals whose termination of medical assistance was effective on or
		  after March 18, 2020. In accordance with section 6008 of the Families First
		  Coronavirus Response Act (FFCRA) (Pub. L. No. 116-127), the administrative
		  agency shall reinstate medical assistance for any individual whose
		  discontinuance of coverage was effective on or after March 18, 2020, except
		  when the discontinuance was due to death, state residence, or the
		  individual's voluntary request.
(L) Timely determinations and renewals. The administrative
		  agency shall make a timely determination of an individual's eligibility
		  for medical assistance under this chapter of the Administrative Code. The
		  administrative agency shall determine initial eligibility or a renewal of
		  eligibility, including obtaining verifications when required,
		  within:
(1) Ten calendar days of
			 receiving a report of a change that could affect an individual's ongoing
			 eligibility for medical assistance; or
(2) Forty-five calendar
			 days from the date of application or scheduled renewal, unless:
(a) An individual who otherwise meets the conditions of
				eligibility described in this chapter of the Administrative Code alleges
				blindness or disability. The administrative agency shall determine eligibility
				within ninety calendar days from the date of application unless the examining
				physician delays or fails to take a required action; or
(b) There is an administrative or other emergency beyond the
				administrative agency's control.
(M) Effective dates of eligibility.
(1) Medical assistance
			 coverage begins on the first day of the calendar month in which the application
			 which resulted in eligibility was submitted to the administrative agency,
			 except that:
(a) An individual's coverage cannot begin before the date on
				which the individual:
(i) Became a resident of
				  Ohio; or
(ii) Was
				  born.
(b) The administrative agency shall approve retroactive
				eligibility for medical assistance effective no later than the first day of the
				third month before the month of application if the individual:
(i) Reports he or she
				  received medical services of a type covered by medical assistance within the
				  three months prior to the application month; and
(ii) Requests retroactive
				  eligibility be determined; and
(iii) Would have been eligible for medical assistance at the
				  time the services were provided if an application had been made at that time,
				  regardless of whether the individual was alive when the application actually
				  was made. Actual income received in each retroactive month shall be used to
				  determine eligibility for that month.
(iv) Is eligible for a category of medical assistance other
				  than:
(a) Transitional medical assistance as described in rule
					 5160:1-4-05 of the Administrative Code; or
(b) Medicare premium assistance as described in rule
					 5160:1-3-02.1 of the Administrative Code; or
(c) Any presumptive eligibility category described in rule
					 5160:1-2-13 of the Administrative Code.
(2) Medical assistance
			 coverage discontinues on the last day of a calendar month, except that coverage
			 discontinues on the date an individual:
(a) Becomes a resident of another state; or
(b) Dies; or
(c) Requests that coverage be discontinued.
(N) Duration of eligibility span. The administrative agency
		  shall:
(1) Discontinue coverage
			 under a time-limited medical assistance category as described in the
			 Administrative Code rule for the appropriate medical assistance category. These
			 time-limited eligibility categories include:
(a) Any presumptive eligibility category, as described in rule
				5160:1-2-13 of the Administrative Code, and
(b) Alien emergency medical assistance (AEMA), as described in
				rule 5160:1-5-06 of the Administrative Code, and
(c) Refugee medical assistance (RMA), as described in rule
				5160:1-5-05 of the Administrative Code.
(2)  Schedule an
			 individual's renewal of eligibility for medical assistance twelve months
			 after the most recent eligibility determination.
(3) Redetermine medical assistance upon
			 receiving a report of a change in circumstances that could affect an
			 individual's eligibility for medical assistance.
(O) Third party liability (TPL). For individuals found
		  eligible for or in receipt of medical assistance, the administrative agency
		  shall report to the Ohio department of medicaid (ODM) any available information
		  about a third party liable for an individual's health care
		  costs.
(1) When determining an
			 individual's eligibility for medical assistance coverage, the agency shall
			 use the form (or an electronic equivalent) designated by the administrative
			 agency to report:
(a) Possible health insurance coverage of an individual. A
				separate report shall be made for each possible health insurance
				policy.
(b) Potential TPL due to an injury, disability, or court
				order.
(2) At renewal, or upon
			 any reported change, the administrative agency shall compare the
			 individual's current information to the information on the most recent ODM
			 06612 "Health Insurance Information Sheet" (rev. 9/2016) or ODM 06613
			 "Accident/Injury Insurance Information" (rev. 12/2016). When any
			 information has changed, the administrative agency shall report the changes to
			 ODM by submitting a new ODM 06612 or ODM 06613, or an electronic
			 equivalent.
(3) Upon a request by
			 ODM, the administrative agency shall contact the individual to obtain
			 information regarding potential TPL. 
(P) Upon a report (verbal or written) of a change of
		  address within the state of Ohio, the administrative agency shall:
(1) Give or mail to the
			 individual a notice meeting the voter registration requirements of section
			 3503.10 of the Revised Code and advise the individual that, upon request, the
			 administrative agency will help the individual register to vote or update voter
			 registration as outlined in rule 5101:1-2-15 of the Administrative
			 Code.
(2) Process an intercounty transfer (ICT)
			 when the individual has changed residence from one county to another. Both the
			 county of original residence and the county of new residence have
			 responsibilities in the ICT process. The ICT process shall be followed whether
			 the individual reporting a change of residence is an applicant or is currently
			 in receipt of medical assistance benefits.
(a) The county department of job and family services (CDJFS)
				receiving report of a move shall determine whether the move is a change of
				residence or a temporary absence from the home. When the move is a temporary
				absence from the home, the county in which the individual is physically located
				shall provide necessary medical and transportation services.
(b) The CDJFS receiving report of a change of residence
				shall:
(i) Update the address in
				  the electronic eligibility system. When the individual does not have an address
				  in the new county, use the address of the administrative agency in the new
				  county.
(ii) When the report is
				  made to the administrative agency in the county of new residence, inform the
				  county of original residence.
(c) Record requirements for intercounty transfers within
				the state.
(i) The CDJFS in the
				  individual's original county of residence shall take the following actions
				  for the identified type of case record:
(a) Electronic records.
					 When the individual moves to another county within the state, the electronic
					 document management system shall be updated with the most recent eligibility
					 determination documentation no later than the end of the business day following
					 the date the CDJFS becomes aware of the address change.
(b) Online records. Prior
					 to the online record being transferred, the CDJFS in the individual's
					 original county of residence shall ensure the electronic eligibility system is
					 updated no later than the end of the business day following the date the CDJFS
					 becomes aware of the address change.
(c) Hard copy records.
					 Hard copy records used in the most recent eligibility determination shall be
					 converted into digital format in the electronic document management system no
					 later than the end of the business day following the date the CDJFS becomes
					 aware of the address change. The remaining hard copy records shall be
					 transferred no later than five calendar days following the date the CDJFS
					 becomes aware of the address change. The CDJFS in the individual's
					 original county of residence shall notify the CDJFS in the individual's
					 county of new residence when a hard copy record is being
					 transferred.
(ii) The case record to
				  be transferred shall contain the following documents:
(a) The most recently
					 signed application for medical assistance; and
(b) Other pertinent
					 documents, such as citizenship, qualified non-citizen status, income, and
					 resource verifications.
(d) The CDJFS in the individual's county of new residence
				shall:
(i) Not require the
				  individual to reapply or cooperate with a renewal of eligibility for medical
				  assistance merely due to the change in county of residence.
(ii) Verify potential
				  changes in income, expenses, employment, or household composition resulting
				  from the change in residence when the CDJFS that received the reported change
				  did not complete the verification prior to the intercounty
				  transfer.
(iii) Provide the medical assistance benefits for which the
				  individual is eligible.
(e) When the case being transferred is subject to a claim for
				overpayment as set out in rule 5160:1-2-04 of the Administrative
				Code:
(i)  An existing claim
				  shall not be transferred. The records transferred to the CDJFS in the county of
				  new residence shall include copies of the documentation of the claim. The CDJFS
				  that established the claim remains responsible for any necessary action on the
				  claim.
(ii) When no claim has
				  been established and the CDJFS in each county agrees the CDJFS in the county of
				  new residence shall establish the claim, then a potential claim may be
				  transferred to the CDJFS in the county of new residence to be established by
				  the CDJFS in that county.
(Q) Distribution of informational materials. The
		  administrative agency:
(1) Shall distribute the internal revenue
			 service (IRS) form 1095-B "Health Coverage" to individuals in January
			 of each calendar year and upon an individual's request in accordance with
			 the Patient Protection and Affordable Care Act (ACA) (Pub. L. No.
			 111-148).
(2) Shall distribute voter information
			 and registration materials to individuals in accordance with 42 C.F.R. 431.307
			 (as in effect on October 1, 2019).
(3) May distribute materials directly
			 related to the health and welfare of applicants and individuals eligible for
			 medical assistance, such as announcements of free medical examinations,
			 availability of surplus food, and consumer protection information.
(R) The administrative agency shall
		  provide timely and adequate written notice of any decision affecting an
		  individual's eligibility, including an approval, denial, discontinuance,
		  or suspension of eligibility, or a denial or change in benefits, consistent
		  with 42 C.F.R. 435.917 (as in effect October 1, 2019) and division 5101:6 of
		  the Administrative Code.