(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