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MedicaidReimbursementMedium impact

5160-1-60.2 - Direct reimbursement for out-of-pocket expenses incurred for medicaid covered services during approved eligibility periods. (New/Final File)

Ohio Medicaid·OH·Reimbursement
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Ohio Medicaid updated rule 5160-1-60.2 regarding direct reimbursement for out-of-pocket expenses incurred for Medicaid covered services during approved eligibility periods. This policy allows Medicaid recipients to seek reimbursement for services they paid for out-of-pocket during periods when their Medicaid eligibility is later approved retroactively.

Action Required

Action needed
Billing teams serving Ohio Medicaid patients should inform patients about potential reimbursement options for out-of-pocket payments made during periods when Medicaid eligibility was pending but later approved. Update patient financial counseling procedures to include information about this reimbursement process for applicable situations.
5160-1-60.2 - Direct reimbursement for out-of-pocket expenses incurred for medicaid covered services during approved eligibility periods. (New/Final File) | Ohio Medicaid | PolicyChanges.app