MedicaidCoverageMedium impact
5160-9-03 - Pharmacy services: covered drugs and associated limitations. (Amend/Final File)
Ohio Medicaid·OH·Pharmacy
Effective date
Feb 16, 2024
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has updated Rule 5160-9-03 regarding pharmacy services covered drugs and associated limitations, with the final amendment taking effect February 16, 2024. This policy change affects which drugs are covered under Ohio Medicaid and any restrictions or limitations on their coverage.
Action Required
By February 16, 2024: Billing and clinical teams should review the updated Ohio Medicaid covered drug list and limitations to ensure prescribed medications are covered. Contact Ohio Department of Medicaid at 614-752-3877 (Tommi Potter) for specific drug coverage questions. Verify coverage before prescribing to Ohio Medicaid patients to avoid claim denials.