(A) A healthy Ohio program participant's participation in the program shall cease if any of the following applies:
(1) Unless the participant is pregnant, a monthly installment payment to the participant's buckeye account is sixty days late.
(2) The participant fails to submit documentation needed for a redetermination of the participant's eligibility for medicaid before the sixty-first day after the documentation is requested.
(3) The participant becomes eligible for medicaid on a basis other than being included in the category identified by the department of medicaid as covered families and children or being included in the eligibility group described in section 1902(a)(10)(A)(i)(VIII) of the "Social Security Act," 42 U.S.C. 1396a(a)(10)(A)(i)(VIII).
(4) The participant becomes a ward of the state.
(5) The participant ceases to be eligible for medicaid.
(6) The participant exhausts the annual or lifetime payout limit specified in division (D) of section 5166.401 of the Revised Code.
(7) The participant requests that the participant's participation be terminated.
(B) A healthy Ohio program participant who ceases to participate in the program under division (A)(1) or (2) of this section may not resume participation until the former participant pays the full amount of the monthly installment payment or submits the documentation needed for the former participant's medicaid eligibility redetermination. The former participant shall not be transferred to the fee-for-service component of medicaid or the care management system as a result of ceasing to participate in the healthy Ohio program under division (A)(1) or (2) of this section.
(C) Except as provided in section 5166.407 of the Revised Code, a healthy Ohio program participant who ceases to participate in the program shall be provided the contributions that are in the participant's buckeye account at the time the participant ceases participation.
Added by 131st General Assembly File No. TBD, HB 64, ยง101.01, eff. 9/29/2015.
Section: Previous 5166.309 5166.3010 5166.32 5166.35 5166.40 5166.401 5166.402 5166.403 5166.404 5166.405 5166.406 5166.407 5166.408 5166.409 NextLast modified: October 10, 2016