MedicaidAdministrativeMedium impact
5160:1-3-03.5 - Medicaid: application of income standards. (Amend/Final File)
Ohio Medicaid·OH·Enrollment
Effective date
Jun 8, 2025
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid has amended Rule 5160:1-3-03.5 regarding the application of income standards for Medicaid eligibility determination. This is an administrative update to income thresholds and eligibility criteria that may affect patient coverage status and billing for Medicaid beneficiaries in Ohio.
Action Required
Before June 8, 2025: Billing team should verify Medicaid eligibility for all Ohio patients before service dates on or after the effective date, as income standard changes may affect patient coverage status. Update eligibility verification procedures to account for revised income thresholds that could impact patient eligibility.