MedicaidAdministrativeMedium impact
5160-26-06 - Managed health care programs: program integrity - fraud, waste and abuse, audits, reporting, and record retention. (Amend/Final File)
Ohio Medicaid·OH·Program Integrity
Effective date
Jul 18, 2022
We identified it
Jun 20, 2026
Summary
Ohio Department of Medicaid has updated Rule 5160-26-06 regarding program integrity requirements for fraud, waste and abuse prevention, audits, reporting, and record retention for managed health care programs. This is the most recent amendment in an ongoing series of updates to strengthen Medicaid program integrity measures.
Action Required
Review current compliance procedures for Ohio Medicaid managed care plans to ensure alignment with updated program integrity requirements. Billing team should verify that audit preparation, fraud prevention protocols, and record retention policies meet the amended standards. Contact Ohio Department of Medicaid at 614-752-3877 for specific compliance questions.