Current through all regulations passed and filed through September 16, 2024
(A)
The following
definitions apply to Chapter 5160-70 of the Administrative Code:
(1)
"Appellant"
means the party who requested an adjudication hearing pursuant to Chapter 119.
of the Revised Code and is appealing the adjudication order to the Franklin
county court of common pleas.
(2)
"Certified mail"
means the United States postal service mail service in which the delivery
person obtains the signature of the recipient of the mail on a form as proof of
delivery to the specified addressee. Pursuant to section
1.02 of the Revised Code,
certified mail includes registered mail.
(3)
"Department"
means the Ohio department of medicaid ("ODM").
(4)
"Depository
agent" means the ODM office of legal services at its official mailing address
for the purpose of receiving correspondence or filings for any hearing held
under authority of Chapter 5160-70 of the Administrative Code.
(5)
"Director" means
the director of ODM.
(6)
"Adjudication order" means the order made by the
director after notice and an opportunity for a hearing is afforded pursuant to
Chapter 119. of the Revised Code.
(7)
"Final fiscal
audit" means a medicaid final rate settlement or a medicaid hospital final
settlement, including a final settlement in which Title V monies are offset
against medicaid monies proposed for adjudication by ODM.
(8)
"Hearing" means
a hearing held by ODM in compliance with sections
119.06 to
119.13 of the Revised
Code.
(9)
"Last known address" means the most recent mailing
address reported to ODM in compliance with reporting
requirements.
(10)
"Notice of intended action" means the written notice
to the party of the department's intended action and notice of the right to a
hearing pursuant to Chapter 119. of the Revised Code.
(11)
"ODM" means the
Ohio department of medicaid.
(12)
"Participants
in the hearing" means the party and the party's counsel in the hearing and ODM
and ODM's counsel in the hearing.
(13)
"Party" means a
person whose interests are the subject of a notice of intended action by
ODM.
(14)
"Person" means an individual, corporation, whether
nonprofit or for profit, a partnership, a limited liability company, and
unincorporated society or association.
(15)
"Medicaid
provider" or "provider" means a person or governmental entity with a valid
provider agreement to provide medical services or supplies to medicaid
recipients. To the extent appropriate in the context, "medicaid provider" or
"provider" includes a person or governmental entity applying for a provider
agreement, a former medicaid provider, or both.
(16)
"Notice by
ordinary mail" means the service obtained by the agency after the party fails
to claim the certified mail notice and the agency sends the notice by ordinary
mail using a certificate of mailing to the party's last known address and the
ordinary mail notice is not returned showing failure of
delivery.
(17)
"Provider agreement" means a contract between ODM and
a person or governmental entity that allows the person or governmental entity
to provide medical services and supplies for the Ohio medicaid
program.
(18)
"Take any action based on a final fiscal audit" means
ODM issuing a notice of intended action seeking recovery of medicaid
overpayments that were identified in the final fiscal audit.
(B)
Computation of time deadlines
Section
1.14 of the Revised Code
controls the computing of time deadlines imposed by Chapter 119. of the Revised
Code and Chapter 5160-70 of the Administrative Code. The time within which an
act is required by law to be completed is computed by excluding the first day
and including the last day. When the last day falls on a Saturday, Sunday, or
legal holiday, the act may be completed on the next succeeding day that is not
a Saturday, Sunday, or legal holiday. When the last day to perform an act that
is required by law to be performed in a public office occurs when that public
office is closed to the public for the entire day, the act may be performed on
the next succeeding day that is not a Saturday, Sunday, or legal holiday and on
which the public office is open.
