(A)What is a program integrity review?
A program integrity review carried out for
the publicly funded child care program is meant to ensure:
(1)The program is limited to only eligible
recipients.
(2)Payments to providers are for actual services
provided.
(3)Payments to providers conform to program
rules.
(B)Who performs program integrity reviews?
The following entities may perform program
integrity reviews for the publicly funded child care program:
(1)The Ohio department of job and family services
(ODJFS).
(2)A county department of job and family services.
(3)The Ohio auditor of state.
(4)The Ohio attorney general.
(5)The Ohio inspector general.
(6)The U.S. department of health and human
services (HHS).
(7)The HHS office of inspector general.
(8)The U.S. government accountability office.
(9)Any entity working on behalf of ODJFS or
the federal government.
(C)Who shall comply with publicly funded child
care program integrity reviews?
Child care providers with a provider agreement
or who had a provider agreement pursuant to rule 5101:2-16-09 of the Administrative
Code, and caretakers determined eligible for publicly funded child care benefits
pursuant to rule 5101:2-16-02 of the Administrative Code shall cooperate and participate
in reviews conducted by any of the entities listed in paragraph (B) of this rule.
(D)What documentation and records will child
care providers be required to provide as part of a program integrity review?
(1)Child care providers shall provide all documentation
and records which are required to be maintained by Chapters 3301-32, 3301-37, 5101:2-12,
5101:2-13, 5101:2-14, 5101:2-16 and 5101:2-18 of the Administrative Code.
(2)Child care providers shall provide the documents
and records listed in paragraph (D)(1) of this rule immediately upon request or
no later than fifteen days from the date the child care provider receives notice
of the request.
(3)Child care providers shall provide all documentation
and records required to be maintained on-site immediately upon request during an
on-site review.
(E)What happens if a child care provider fails
to comply with a program integrity review request?
If a child care provider fails to comply with
a program integrity review request, ODJFS may do both of the following:
(1)Terminate the provider agreement entered
into with ODJFS pursuant to rule 5101:2-16-09 of the Administrative Code.
(2)Determine an overpayment for any claims
under examination as part of the review.
(F)What happens if ODJFS determines misuse
of publicly funded child care or the automated child care system pursuant to rule
5101:2-16-11 of the Administrative Code?
ODJFS may do any of the following:
(1)Recoup all improper payments due to misuse
of publicly funded child care.
(2)Terminate the provider agreement entered
into with ODJFS pursuant to rule 5101:2-16-09 of the Administrative Code.
(G)If ODJFS terminates a provider agreement
pursuant to this rule, when can the provider request a new agreement?
A child care provider whose provider agreement
has been terminated pursuant to this rule may not re-enter into a provider agreement
for a period of five years from the date of termination.
Replaces: 5101:2-16-72
Effective: 10/20/2019
Five Year Review (FYR) Dates: 10/20/2024
Certification: CERTIFIED ELECTRONICALLY
Date: 10/10/2019
Promulgated Under: 119.03
Statutory Authority: 5104.38
Rule Amplifies: 5104.37
Prior Effective Dates: 05/04/2014, 08/10/2015, 12/16/2018