MedicaidAdministrativeHigh impact
5160-26-05 - Managed care: provider network and contracting requirements. (New/Final File)
Ohio Medicaid·OH·Managed Care
Effective date
May 5, 2025
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has issued a comprehensive update to Rule 5160-26-05 governing managed care provider network and contracting requirements. This represents a complete rescission and replacement of the previous rule, indicating significant changes to how providers must contract with and participate in Ohio Medicaid managed care networks.
Action Required
By May 5, 2025: All providers participating in Ohio Medicaid managed care must review and comply with updated contracting and network requirements under Rule 5160-26-05. Contact Ohio Department of Medicaid (Tommi Potter, 614-752-3877) to obtain the complete new rule text and ensure current contracts and network participation agreements meet the revised standards. Failure to comply may result in network termination or claims processing issues.