MedicaidAdministrativeMedium impact
5160-28-01 - Cost-based clinics: definitions and explanations. (Rescind/Final File)
Ohio Medicaid·OH · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has rescinded Rule 5160-28-01 regarding cost-based clinic definitions and explanations, replacing it with new rules specifically for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). This regulatory change consolidates and updates how these specialized clinic types are defined and regulated under Ohio Medicaid.
Action Required
Billing teams at FQHCs and RHCs in Ohio should review current Medicaid enrollment status and billing procedures to ensure compliance with the new FQHC and RHC-specific rules that replaced the general cost-based clinic regulations. Verify that clinic type designation is correctly reflected in billing systems and Medicaid provider enrollment.