Publicly funded child care program integrity review

(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 programs are for actual services provided.

(3) Payments to programs conform to program rules.

(B) Who performs program integrity reviews? The following entities may perform program integrity reviews for the publicly funded child care (PFCC) program:

(1) The Ohio department of children and youth (DCY).

(2) A county department of job and family services (CDJFS).

(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 DCY or the federal government.

(C) Who is to comply with PFCC program integrity reviews? Child care programs with a provider agreement or who had a provider agreement pursuant to rule 5180:6-1-09 of the Administrative Code, and caretakers determined eligible for PFCC benefits pursuant to rule 5180:6-1-02 of the Administrative Code are to 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 programs be required to provide as part of a program integrity review?

(1) Child care programs are to provide all documentation and records which are required to be maintained by Chapters 5180:2-12, 5180:2-13, 5180:2-14, 5180:2-18, 5180:2-19, 5180:2-20, 5180-32, 5180-37, and 5180:6-1 of the Administrative Code.

(2) Child care programs are to 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 program receives notice of the request.

(3) Child care programs are to 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 program fails to comply with a program integrity review request? If a child care program fails to comply with a program integrity review request, DCY may do both of the following:

(1) Terminate the provider agreement entered into with DCY pursuant to rule 5180:6-1-09 of the Administrative Code.

(2) Determine an overpayment for any claims under examination as part of the review.

(F) What happens if DCY determines misuse of PFCC or the automated child care system pursuant to rule 5180:6-1-11 of the Administrative Code? DCY may do any of the following:

(1) Recoup all improper payments due to misuse of PFCC.

(2) Terminate the provider agreement entered into with DCY pursuant to rule 5180:6-1-09 of the Administrative Code.

(G) If DCY terminates a provider agreement pursuant to this rule, when can the program request a new agreement? A child care program 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.