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MedicaidAdministrativeMedium impact

5160:1-3-04.1 - Medicaid: eligibility through the spenddown process. (Rescind/Final File)

Ohio Medicaid·OH·Enrollment
Effective date
Jul 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Ohio Department of Medicaid has rescinded rule 5160:1-3-04.1 regarding Medicaid eligibility through the spenddown process. This rule, which was effective from July 1, 2021, has been formally removed from the regulations, eliminating the previous guidelines for determining Medicaid eligibility based on spenddown calculations.

Action Required

Action needed
Billing team should verify current Ohio Medicaid eligibility verification processes since the spenddown rule has been rescinded. Contact Ohio Department of Medicaid at 614-752-3877 for clarification on updated eligibility determination procedures. Review any patients who may have been enrolled through previous spenddown processes to ensure continued coverage verification.