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MedicaidAdministrativeMedium impact

5160:1-2-03 - Medicaid: request for home and community-based services (HCBS) waiver. (Amend/Final File)

Ohio Medicaid·OH · Family Medicine, Internal Medicine, Geriatrics +2 more·Specialty Services
Effective date
Nov 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Ohio Department of Medicaid has updated Rule 5160:1-2-03 regarding requests for Home and Community-Based Services (HCBS) waiver applications. This amendment affects the process for requesting Medicaid waiver services that allow eligible individuals to receive long-term care services in their homes or community settings rather than institutional care.

Action Required

Action needed
By November 1, 2025: Billing teams serving Ohio Medicaid patients requiring HCBS waiver services must review and update their waiver request procedures according to the new Rule 5160:1-2-03 requirements. Contact the Ohio Department of Medicaid at 614-752-3877 for specific procedural changes. Ensure staff handling HCBS waiver requests are trained on the updated requirements to avoid delays in patient service authorization.