As Introduced
136th General Assembly
Regular Session H. B. No. 130
2025-2026
Representatives LaRe, Brennan
Cosponsors: Representatives Gross, Mohamed, White, E., Brewer, Isaacsohn,
Baker, Synenberg, Williams, Richardson
A B I L L
To enact section 5162.213 of the Revised Code
regarding notification requirements for the
Medicaid Estate Recovery Program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 5162.213 of the Revised Code be
enacted to read as follows:
Sec. 5162.213. (A)(1) Upon application, the department of
medicaid shall notify each applicant for any medicaid program
component subject to the medicaid estate recovery program
instituted under section 5162.21 of the Revised Code of the
existence of the medicaid estate recovery program, including the
information specified in division (B)(1) of this section.
(2) The department of medicaid shall again notify each
applicant described in division (A)(1) of this section about the
medicaid estate recovery program, including the information
specified in division (B)(2) of this section, when the
application is approved.
(3) In addition to the notice required by divisions (A)(1)
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As Introduced
and (2) of this section, the department also shall create both
of the following:
(a) A consumer-focused notification that explains in plain
language how the medicaid estate recovery program functions,
including example scenarios. The department shall engage
medicaid consumers to participate in the development and review
of the notification and any additional materials that will
accompany it.
(b) A notification for medicaid enrollees who may be at
risk of being subject to the medicaid estate recovery program
that lists available resources for consumer support, such as
legal aid and estate planning resources.
(B) The director of medicaid shall adopt rules to ensure
compliance with this section, as follows:
(1) The rules shall require the first page of the medicaid
application to be a document that includes all of the following
information:
(a) A statement that if the enrollee is enrolled in any
program described by section 5162.21 of the Revised Code, the
enrollee's estate may be subject to recovery after the
enrollee's death;
(b) A list of health care and other services to which the
medicaid estate recovery program applies;
(c) The per member per month capitation payment, or
managed care premium, amount paid by the department to each
medicaid managed care organization in the previous calendar
year. As used in this division, "capitation payment" has the
same meaning as defined in 42 C.F.R. 483.2.
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As Introduced
(2) The rules shall require that an approved medicaid
eligibility determination notice sent to enrollees as required
under 42 C.F.R. 435.917 include both the information required
under division (B)(1) of this section and a document that
contains the following information:
(a) How to file a complaint with the department regarding
the enrollee's medicaid benefits;
(b) How to inquire about the status of medicaid benefits;
(c) How to disenroll from the medicaid program.
(3) The rules shall specify the form and dissemination of
the notifications described in division (A)(3) of this section,
including a process for identifying medicaid enrollees who may
be at risk of being subject to the medicaid estate recovery
program.
The rules shall be adopted in accordance with Chapter 119.
of the Revised Code.
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