MedicaidAdministrativeMedium impact
5160-45-08 - ODM-administered waiver programs: criminal records checks involving independent providers. (Amend/Final File)
Ohio Medicaid·OH·Specialty Services
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid updated Rule 5160-45-08 regarding criminal background check requirements for independent providers working in ODM-administered waiver programs. This expands the previous scope which only covered home care, transitions DD, and transitions carve-out waivers to now include all ODM waiver programs.
Action Required
By January 1, 2026: Billing teams working with Ohio Medicaid waiver programs must verify that all independent providers have completed required criminal background checks before submitting claims. Contact providers to confirm compliance status and maintain documentation. Claims for services by non-compliant providers may be denied or subject to recoupment.