MedicaidAdministrativeMedium impact
5160-59-02 - OhioRISE: eligibility and enrollment. (Amend/Final File)
Ohio Medicaid·OH · Pediatrics, Psychiatry·Enrollment
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Summary
Ohio Rule 5160-59-02 for OhioRISE eligibility and enrollment has been amended with an effective date of July 1, 2026. This rule governs eligibility criteria and enrollment processes for Ohio's specialized Medicaid program serving children and youth with complex behavioral health needs.
Action Required
Before July 1, 2026: Billing teams serving pediatric behavioral health patients in Ohio should review updated OhioRISE eligibility criteria and enrollment procedures. Contact Ohio Department of Medicaid at 614-752-3877 for specific program requirements. Ensure staff understand any changes to patient eligibility verification processes for this specialized Medicaid program.