Traditional MedicareAdministrativeMedium impact
5160:1-3-02.1 - Medicare premium assistance programs (MPAP). (Amend/Final File)
Ohio Medicaid·OH·Medical Policy
Effective date
Nov 1, 2025
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid has amended Rule 5160:1-3-02.1 regarding Medicare Premium Assistance Programs (MPAP), with the final amendment effective November 1, 2025. This policy governs how Ohio Medicaid assists with Medicare premium payments for dual-eligible beneficiaries.
Action Required
By November 1, 2025: Billing team should review patient eligibility verification processes for dual-eligible Medicare-Medicaid beneficiaries in Ohio to ensure compliance with updated MPAP requirements. Contact Ohio Medicaid at 614-752-3877 for specific guidance on any changes to premium assistance coordination that may affect billing workflows.