Welcome to the Ohio Department of Job & Family Services Casualty Recovery Website

 

 

Medicaid Casualty Recovery Overview

 

Section 1902(a)(25) of the Social Security Act, 42 CFR 433.135, requires that States take all reasonable measures to ascertain the legal liability of third parties to pay for medical services furnished to a Medicaid recipient.  Pursuant to 1902(a)(25) the State of Ohio enacted Ohio Revised Code Section 5101.58, which gives the Department of Job and Family Services (ODJFS) a statutory right of recovery against the liability of any third party for the cost of medical services and care arising out of the injury, disease, or disability of a Medicaid recipient.

 

ODJFS contracted with Health Management Systems Inc., (HMS) to identify, manage, and recover all Medicaid paid funds when a Medicaid recipient was involved in a tort or casualty accident/incident.  If you are an attorney with a Medicaid recipient client involved in a tort accident /incident, or if you are an insurance adjuster involved in a case where a Medicaid recipient was injured, and you want to obtain a listing of all of the bills that Medicaid paid, please do the following:

 

1.     Complete a Referral Form and return it to the ODJFS Tort Recovery Unit with a HIPAA compliant Medical Release Authorization signed by the Medicaid recipient.

 

2.     When we receive this form and release, we will enter the data into our Case Management System.  This System will generate a Subrogation/Recovery letter that we will send to you citing ODJFS' right to recovery of Medicaid paid funds.

 

Approximately two (2) - three (3) weeks after we send the Subrogation/Recovery letter, we will send you a claims printout of claims that ODJFS paid that we believe are related to the accident/incident.  This printout will represent either an Interim or a Final statement of the aid paid by ODJFS.  This printout will be the official subrogated interest of the State of Ohio.

 

If you have any questions, please feel free to contact us.

 

 
 

Ohio Tort Recovery Unit

350 Worthington Rd, Suite G,

Westerville, Ohio 43082

Local: 614-242-1045

Toll Free: 888-245-9019

Fax:614-242-1051

Email: ohiotort@hms.com

DISCLAIMER

HMS, Inc is solely responsible for the accuracy and completeness of the content of this website.