MedicaidAdministrativeMedium impact
5160-26-09.1 - Managed care: third party liability and recovery. (Amend/Final File)
Ohio Medicaid·OH·Managed Care
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has updated Rule 5160-26-09.1 regarding managed care third party liability and recovery procedures. This is a recent amendment to existing procedures for handling situations where other insurance coverage may be primary to Medicaid managed care plans.
Action Required
By April 1, 2025: Billing teams in Ohio should review updated third party liability procedures for Medicaid managed care plans. Contact the Ohio Department of Medicaid at 614-752-3877 for specific procedural changes. Ensure coordination of benefits processes align with the new rule requirements to avoid claim processing delays.