HCAP Frequently Asked Questions 

Click here to review an FAQ developed for OHA members.

This OHA member resource answers most frequently asked questions regarding the Ohio Hospital Care Assurance Program, or HCAP, its related hospital free care requirement and Ohio Medicaid DSH program audits.

These FAQs reflect requirements in Ohio Administrative Code (OAC) 5160-2-07.17, established by the Ohio Department of Medicaid (ODM) on the allowance and documentation of free and uninsured hospital services related to HCAP.

They are designed to provide guidance to hospitals, but they do not reflect any particular legal interpretation on the part of OHA or ODM and are not intended to provide counsel to consumers about the requirements of OAC 5160-2-07.17. OHA recommends hospitals review their “HCAP” and other charity care policies and procedures with legal counsel to ensure they are in compliance with all state and federal laws and rules.
OHA reminds hospitals that Ohio Medicaid eligibility guidelines should allow most Ohio residents who qualify for free hospital care to also qualify for full Medicaid benefits.  OHA encourages hospitals to ensure that each patient has applied for Medicaid as part of the free care application process, as outlined in OAC 5160-2-07.17(B)(7). 
All public rules and provider manuals are available on the ODM website. Go to “Resources – Publications – eManuals – Medicaid-Provider – Hospital Handbook – Hospital Services Ohio Administrative Code.
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