MedicaidAdministrativeLow impact
5160-9-10 - Ohio average acquisition cost (OAAC) appeal and managed care pharmacy dispensing fee modification request. (New/Final File)
Ohio Medicaid·OH·Pharmacy
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Ohio has established a new rule allowing pharmacies to appeal Ohio Average Acquisition Cost (OAAC) determinations and request modifications to managed care pharmacy dispensing fees. This creates a formal process for pharmacy cost disputes in Ohio Medicaid.
Action Required
No immediate action required for billing teams. This rule establishes an appeals process for pharmacies, not billing procedures for medical practices. Monitor for any related pharmacy billing changes if your practice has an in-house pharmacy or dispenses medications.