This SHMTL contains two rules from Chapter 5101:6-2, one rule from Chapter 5101:6-4, two rules from Chapter 5101:6-6, one rule from Chapter 5101:6-7, and three rules from Chapter 5101:6-20 of the Administrative Code. These rules were filed as part of a five-year rule review. The effective date of the amended rules is February 28, 2014. The effective date of the no change rules remains September 1, 2008.

SHM 1000.

5101:6-2-40 "State Hearings: Coordinated Services Program State Hearing and Notice Requirements". This amended rule sets forth the hearing process for the Medicaid "Coordinated Services Program" (CSP). The rule includes hearing and notice rights associated with proposed enrollment into the CSP, continued enrollment into the CSP, and denial of a designated provider change. Changes are limited to correcting references from Ohio Department of Job and Family Services to Ohio Department of Medicaid. Also, statutory citations were corrected.

5101:6-2-51 "Notice of Interim Assistance Reimbursement". This no change rule sets forth the agency's notice requirements for individuals receiving supplemental security income (SSI) and public assistance.

5101:6-4-01 "Continuation of Benefits when a State Hearing is Requested". This amended rule sets forth the grounds by which an individual is, or is not, entitled to receive fair hearing benefits when a hearing request is received timely. This rule also encompasses benefits received under a Medicaid fee-for-service provider or a managed care plan. Changes are limited to update Administrative Code citations and statutory references to Medicaid.

5101:6-6-03 "Tape Recording of the Hearing". This amended rule explains the recording of the hearing is not an official part of the hearing record. The rule also describes the period of time in which a taped recording of a state hearing is retained by state hearings. Finally, the rule also describes the availability of rehearing a case when the taped recording is inaudible. Rule changes are limited to correcting statutory amplification to reference Medicaid.

5101:6-6-04 "Telephone Hearings and Hearings Involving Participation by Telephone". This amended rule describes the process by which an individual and local agency may participate in the state hearing by telephone. It also informs the parties how evidence would be collected and made available to the hearing officer. Finally, it requires the hearing officer to provide a description of the evidence made available to the parties during the phone hearing. Changes are limited to adding Medicaid to the statutory amplification.

5101:6-7-02 "Standards for Revising Community Spouse Income and Resource Allowances at a State Hearing". This amended rule sets forth the standards by which an individual receiving Medicaid can request a state hearing regarding the community spouse's minimum monthly maintenance needs allowance (MMMNA) or the community spouse resource allowance (CSRA). This rule also describes the method by which the hearing officer would calculate an amended MMMNA or CSRA. Finally, the rule informs the individual a hearing will be overruled if the individual has not availed himself or herself of all available sources of income. Changes include correcting Administrative Code citations and statutory amplification.

SHM 2000.

5101:6-20-11 "State hearings: consolidation of an administrative disqualification hearing with a state hearing". This rule sets forth the process by which an individual can combine a state hearing with an administrative disqualification hearing. The rule allows the individual to waive the 30-day advance notice period, and it requires Ohio Department of Job and Family Services to issue two separate decisions, based on the respective issues.

This rule is being amended to add 5160.011 to the statutory amplification.

5101:6-20-13 "Effect of a Pending Administrative Disqualification Hearing". This no change rule requires the local agency to make benefit determinations, despite a pending administrative disqualification hearing, to take action regarding an individual's case, and to issue notice, accordingly.

5101:6-20-19 "Opportunity for Appeal of an Administrative Disqualification". This no change rule describes the legal remedies an individual has with respect to an adverse administrative disqualification hearing (ADH) decision. This rule also informs the individual of the opportunity for a new ADH if it is reversed by the court of common pleas.

SHM Instructions:

This information is also available on the Internet and may be accessed at:

ODJFS Electronic Manuals: http://emanuals.jfs.ohio.gov/

InnerWeb Calendar:http://www.odjfs.state.oh.us/lpc/calendar/staff/

Internet Calendar:http://www.odjfs.state.oh.us/lpc/calendar/