(A)What is a program
integrity review?
Program integrity reviews include reviews, audits, investigations,
and other activities carried out to ensure public programs are limited to only eligible
participants, and payments to providers are for actual services provided and conform
to program rules.
(B)Who performs program
integrity reviews?
The Ohio department of job and family services (ODJFS) performs program
integrity reviews along with the Ohio auditor of state, Ohio attorney general, Ohio
inspector general, U.S. department of health and human services (HHS), the HHS office
of inspector general, and the U.S. government accountability office.
(C)Who shall comply
with publicly funded child care program integrity reviews?
Child care providers with a provider agreement pursuant to rule 5101:2-16-44
of the Administrative Code and caretakers determined eligible for publicly funded
child care pursuant to rule 5101:2-16-30 of the Administrative Code shall cooperate
and participate in reviews conducted by ODJFS, the Ohio auditor of state, the Ohio
inspector general, the Ohio attorney general, any entity acting on behalf of ODJFS,
or the federal government.
(D)When shall child
care providers provide documentation and records which are required to be maintained
by Chapters 5101:2-12, 5101:2-13, 5101:2-14, 5101:2-16 and 5101:2-18 of the Administrative
Code?
(1)Child care providers
shall provide documentation and records immediately upon request or no later than
fifteen days from the date the child care provider receives notice of the request.
(2)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?
ODJFS may do any of the following:
(1)Suspend the provider
agreement entered into with ODJFS pursuant to rule 5101:2-16-44 of the Administrative
Code and in accordance with section 5104.37 of the Revised Code.
(2)Terminate the provider
agreement entered into with ODJFS pursuant to rule 5101:2-16-44 of the Administrative
Code.
(3)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 Ohio electronic child care (Ohio ECC)the automated child care system as defined pursuant to paragraph
(B) of rule 5101:2-16-71 of the Administrative Code?
ODJFS may do any of the following:
(1)Suspend the provider
agreement entered into with ODJFS pursuant to rule 5101:2-16-44 of the Administrative
Code and in accordance with section 5104.37 of the Revised Code.
(2)Terminate the provider
agreement entered into with ODJFS pursuant to rule 5101:2-16-44 of the Administrative
Code.
(G)If ODJFS terminates
a provider agreement pursuant to this rule, when can the provider request a new
agreement?
Child care providers 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.
Effective: 12/16/2018
Five Year Review (FYR) Dates: 8/1/2020
Certification: CERTIFIED ELECTRONICALLY
Date: 12/06/2018
Promulgated Under: 119.03
Statutory Authority: 5104.38
Rule Amplifies: 5104.37
Prior Effective Dates: 05/04/2014, 08/10/2015