Regards Medicaid Estate Recovery Program notification requirement

As Passed by the House

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, Lampton, Mullins, Stephens, Abdullahi, Barhorst, Brent,
Brownlee, Click, Cockley, Denson, Glassburn, Grim, Hall, D.,
Jarrells, Jones, Lear, Lett, Mathews, A., Mathews, T., McNally,
Miller, J., Newman, Odioso, Oelslager, Peterson, Piccolantonio,
Plummer, Rader, Ray, Robb Blasdel, Robinson, Roemer, Rogers, Russo,
Salvo, Schmidt, Sigrist, Somani, Swearingen, Thomas, C., Thomas, D.,
Tims, Troy, Young

A
BILL

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) 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.

(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.