MedicaidAdministrativeMedium impact
5160-26-08.4 - Managed care: appeal and grievance system. (Amend/Final File)
Ohio Medicaid·OH·Managed Care
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid has amended rule 5160-26-08.4 regarding the managed care appeal and grievance system, effective January 1, 2023. This policy change affects how providers and patients can file appeals and grievances with Ohio Medicaid managed care plans.
Action Required
Review updated Ohio Medicaid managed care appeal and grievance procedures. Update staff training materials and patient information regarding appeal processes for denied claims or coverage decisions. Ensure billing team knows current timeframes and requirements for filing appeals with Ohio Medicaid managed care plans.