MedicaidAdministrativeLow impact
5160-3-04 - Payment during the Ohio department of medicaid (ODM) administrative appeals process for denial or termination of a provider agreement. (Amend/Final File)
Ohio Medicaid·OH·Reimbursement
We identified it
Jun 20, 2026
Summary
Ohio Medicaid has updated rule 5160-3-04 regarding payment processes during administrative appeals for provider agreement denials or terminations. This policy governs how billing and reimbursement are handled while appeals are pending with the Ohio Department of Medicaid.
Action Required
Ohio Medicaid providers should review updated rule 5160-3-04 to understand current payment procedures during administrative appeals processes. Contact Ohio Department of Medicaid at 614-752-3877 if facing provider agreement appeals to understand billing implications during the appeals process.