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Ohio Revised Code

Ohio Rev. Code § 5160.31 (2026)

Appeals regarding determination of eligibility for medical assistance program

✓ current as of May 2026

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Effective:

September 29, 2013

Latest Legislation:

House Bill 59 - 130th General Assembly

PDF:

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(A) A medical assistance recipient may appeal a decision regarding the recipient's eligibility for a medical assistance program or services available to the recipient under a medical assistance program.

(B) Regarding appeals authorized by this section, the department of medicaid shall do one or more of the following:

(1) Administer an appeals process similar to the appeals process established under section 5101.35 of the Revised Code;

(2) Contract with the department of job and family services pursuant to section 5162.35 of the Revised Code to provide for the department of job and family services to hear the appeals in accordance with section 5101.35 of the Revised Code;

(3) Delegate authority to hear appeals to an exchange or exchange appeals entity.

(C) If a medical assistance recipient files an appeal as authorized by this section, the department of medicaid may do either or both of the following:

(1) Take corrective action regarding the matter being appealed before a hearing decision regarding the matter is issued;

(2) If a hearing decision, administrative appeal decision, or court ruling is against the recipient, take action in favor of the recipient despite the contrary decision or ruling, unless, in the case of a court's ruling, the ruling prohibits the department from taking the action.

Notes of Decisions

Cited in 5 cases (2 in the last 5 years), 2019–2021 · leading case: Underwood v. Ohio Dept. of Job & Fam. Servs., 2019 Ohio 4924 (Ohio Ct. App. 2019).

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Underwood v. Ohio Dept. of Job & Fam. Servs., 2019 Ohio 4924 (Ohio Ct. App. 2019). “{¶8} According to R.C. 5160.31, R.C. 5101.35(E), and R.C. 119.”

Bacon v. Ohio Dept. of Medicaid, 2019 Ohio 3226 (Ohio Ct. App. 2019). “R.C. 5160.31(B)(2) authorizes the Ohio Department of Job and Family Services to handle the administrative- appeal process for appeals filed in accordance with R.”

Bacon v. Ohio Dept. of Medicaid, 2021 Ohio 4537 (Ohio Ct. App. 2021). “R.C. 5160.31(B)(2) authorizes the Ohio Department of Job and Family Services to handle the administrative-appeal process for appeals filed in accordance with R.”

State ex rel. Small World Early Learning Ctr. v. Ohio Dept. of Job & Fam. Servs., 2019 Ohio 4329 (Ohio Ct. App. 2019). · cites it 2× “An administrative appeal decision is the final decision of the department and, except as provided in section 5160.31 of the Revised Code, is binding upon the department and agency, unless it is reversed or modified on appeal to the court of common pleas.”

Midkiff v. Ohio Dept. of Job & Fam. Serv., 2021 Ohio 479 (Ohio Ct. App. 2021). “{¶ 11} The applicable standard of review for a trial court in an administrative appeal authorized under R.C. 5160.31(B)(2) and 5101.35(E) is governed by R.”

— Ohio Rev. Code § 5160.31(B)(2) — 3 cases

Bacon v. Ohio Dept. of Medicaid, 2019 Ohio 3226 (Ohio Ct. App. 2019). “R.C. 5160.31(B)(2) authorizes the Ohio Department of Job and Family Services to handle the administrative- appeal process for appeals filed in accordance with R.”

Bacon v. Ohio Dept. of Medicaid, 2021 Ohio 4537 (Ohio Ct. App. 2021). “R.C. 5160.31(B)(2) authorizes the Ohio Department of Job and Family Services to handle the administrative-appeal process for appeals filed in accordance with R.”

Midkiff v. Ohio Dept. of Job & Fam. Serv., 2021 Ohio 479 (Ohio Ct. App. 2021). “{¶ 11} The applicable standard of review for a trial court in an administrative appeal authorized under R.C. 5160.31(B)(2) and 5101.35(E) is governed by R.”

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