MedicaidAdministrativeMedium impact
5160:1-2-04 - Medicaid: consumer fraud and erroneous payments. (Rescind/Final File)
Ohio Medicaid·OH·Program Integrity
Effective date
Mar 1, 2024
We identified it
Jun 20, 2026
Summary
Ohio Medicaid is rescinding the old rule 5160:1-2-04 on 'consumer fraud and erroneous payments' and replacing it with a new rule on 'consumer fraud and recoupments' effective March 1, 2024. This represents a terminology and procedural change in how Ohio Medicaid handles fraud cases and payment recoveries.
Action Required
Before March 1, 2024: Billing team should review current Ohio Medicaid fraud and recoupment procedures to understand the transition from 'erroneous payments' to 'recoupments' terminology. Update any internal documentation or staff training materials that reference the old rule 5160:1-2-04. Monitor for additional guidance from Ohio Medicaid on specific procedural changes.