Ohio Tort Hearing Request

Frequently Asked Questions

Why am I receiving this notice?

Effective September 29, 2015, amendments to ORC 5160.37 created hearing rights for persons who want to dispute the amount that Ohio Medicaid was paid, or claims it is owed, to reimburse Medicaid for medical expenses it paid on the person's behalf. The changes in the law create two group of persons with hearing rights:
The first group are persons who have already reimbursed Medicaid and the reimbursement occurred on or after September 29, 2007, but no later than September 28, 2015. This group had until March 27, 2016, to request a hearing.
The second group are persons who have made a payment to Medicaid on or after September 29, 2015, or who will be doing so in the future. This group will be advised of their hearing rights in the final lien letter that they receive from the Ohio Tort Recovery Unit. A person in this group must make a hearing request within 90 days after making payment to Ohio Medicaid. Instead of making payment, a person also has the option of placing the amount owed in escrow or a lawyers' trust account

Do I have to request a hearing?

No. You only need to request a hearing if you want to dispute the amount you paid to Medicaid. If you have no dispute with what you paid, you do not need to request a hearing or take any other action.

Is there a limit to the number of hearing requests I can make?

You can request a hearing for each time you were injured and Medicaid made payments on your behalf, provided that your hearing request is timely made.

Do I need an attorney to file a claim on my behalf?

No.

If I want to request a hearing where do I send the request?

The preferred method of submission is online using this web site.
You may also mail your request to:

Ohio Casualty
PO Box 166529
Irving, TX 75016
Attention: Hearing Requests

What information do I need to provide to request a hearing?

Whether you request a hearing through the website or by mail, you need to provide the following information:
  1. Your case number that has been provided on the letter you received. See below for an example of where you can find the case number on your letter.

  2. Your date of birth.
  3. An address where you can be reached if different than on the letter you received.
  4. A phone number.
Ohio Administrative Code 5160-80-02 requires certain information and documentation to be provided with the hearing request. Failure to provide the following information and documentation will result in a denial of your hearing request:
  1. The total settlement or judgments amount, including the amount, if specified, for medical expenses, loss of income, loss of consortium, pain and suffering, and any other claims as part of your settlement or judgment.
  2. The amount that has been collected by you as a result of the settlement or judgment.
  3. The amount of attorney fees incurred by you to obtain the settlement or judgment.
  4. The amount of costs and expenses, other than attorney fees, incurred by you to obtain the settlement or judgment.
  5. A copy of all written settlement agreements, compromises, judgments, or awards.

After requesting a hearing how soon can I expect to receive a response?

You will receive a letter from Medicaid within 30 days of your hearing request acknowledging receipt of your request.

How long does it take to get a hearing scheduled?

It will depend on the number of hearing requests received and the availability of a hearing examiner to hear your case.

If I request a hearing does that mean I am sure to get money back?

No. To obtain money back, you will need to show at a hearing that Medicaid was paid too much.

What will I need to show to prove Medicaid was paid too much?

You will need documentation to show:
  1. The total dollar value of your medical bills, injuries and other losses. Other losses can include things like loss time at work, damages to property like a car, and pain and suffering caused to you by your injury.
  2. The total dollar value of your settlement or judgment. The total dollar value means what was paid to reimburse you for your losses.
  3. What you received from your judgment or settlement was not enough to fully compensate or reimburse you for your medical bills and other losses and injuries.
You also will need to show at the hearing why Medicaid should have received less than what it received. For example, a person might argue that what Medicaid received was too much when compared to what the person received for his injuries and other losses.
There may be other things you need to show depending on your specific situation.

What will Medicaid argue at the hearing?

In most cases, Medicaid will argue it was not paid too much. A couple examples of what Medicaid may argue include:
  1. In many instances a person's medical bills represent a high percentage or amount of their losses from an injury. Therefore, what Medicaid was paid back for the medical bills was not too much when compared to the person's other losses.
  2. At the time Medicaid was paid it may have agreed to accept less than what it ordinarily would have received. Usually this request was made by the injured person or the person's attorney. Medicaid will raise the fact that it agreed to accept less.

How much will I receive back if I show Medicaid was paid too much?

The amount paid back will depend on what documentation or other evidence you presented at the hearing.

Will I need to testify?

You may decide to testify at the hearing as part of explaining why you believe Medicaid was paid too much. Additionally, the attorney representing Medicaid may call you as a witness.
If both you and the attorney representing Medicaid agree, you can choose not to have an in-person hearing and to simply submit your evidence in writing. The written submission can include affidavits or written statements from you or other witnesses, as well as any documentary evidence that you want to submit.

If I'm not happy with the ruling from the Hearing Examiner, can I appeal?

Yes. You will have a right to an administrative review by the Director of the Ohio Department of Medicaid. If you are not happy with that ruling, you can appeal to the court system.

An attorney represented me at the time I paid Medicaid, but I no longer have the attorney's contact information. Can you give me that information?

At some point after you make a hearing request you will be contacted by the Ohio Attorney General's office. At that time, you may obtain information about your case including any contact information Medicaid has for your attorney.