Beginning October 1, 2013, the federal government launched healthcare.gov, which is also known as the health insurance exchange or marketplace. In Ohio, the exchange is federally facilitated, but the state retains certain authorities to manage and oversee the insurers offering plans on the exchange.
Medicaid is a state and federally funded program that guarantees health care coverage to eligible low-income and medically vulnerable people including: Children (up to 19), pregnant women, parents of children under 18, non-workers with disabilities, Ohioans aged 65 or older, and adults with family income less than 138% of federal poverty.
Medicare is federal health insurance for people age 65 or older, under 65 with certain disabilities and any age with End Stage Renal Disease (permanent kidney failure) requiring dialysis or a kidney transplant.
The Hospital Franchise Fee is a provider tax program that helps fund supplemental Medicaid payments for hospital services and provides additional resources to the state's Medicaid program in order to help ensure the program's payment adequacy and sustainability.
The Hospital Care Assurance Program (or HCAP) is the state's Medicaid disproportionate share (or DSH) program. Funded entirely by hospitals, the program helps offset the uncompensated care of hospitals that serve a disproportionate number of uninsured patients and patients enrolled in Medicaid.
Recovery Audit Contractor (RAC) programs target Medicare and Medicaid payments CMS deems inappropriate and return under and overpayments to the federal government and health care providers.