MedicaidAdministrativeMedium impact
5160:1-4-01 - MAGI-based medicaid: household composition and income. (Amend/Final File)
Ohio Medicaid·OH·Medical Policy
Effective date
Jun 1, 2026
We identified it
Jun 20, 2026
Summary
Ohio has amended Rule 5160:1-4-01 regarding MAGI-based Medicaid household composition and income determination, with changes effective June 1, 2026. This update modifies how Medicaid eligibility is calculated based on household size and income, potentially affecting patient eligibility verification processes.
Action Required
By June 1, 2026: Billing and eligibility verification teams must update procedures for verifying Ohio Medicaid patient eligibility to align with new MAGI-based household composition and income rules. Review and update eligibility verification workflows to ensure accurate Medicaid coverage determination under the amended guidelines.