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MedicaidReimbursementMedium impact

5160-3-43.2 - Resource utilization groups, version III (RUG III): the nursing facility case mix payment system. (Rescind/Final File)

Ohio Medicaid·OH · Geriatrics·Reimbursement
Effective date
Mar 1, 2016
We identified it
Jun 20, 2026
Days to comply

Summary

Ohio Medicaid has rescinded the Resource Utilization Groups version III (RUG III) nursing facility case mix payment system rule 5160-3-43.2, which was replaced by a new nursing facility case mix classification system. This affects billing and reimbursement for nursing facility services under Ohio Medicaid.

Action Required

Action needed
Review current nursing facility billing procedures to ensure compliance with the new case mix classification system that replaced RUG III. Verify that billing software and documentation processes align with the updated Ohio Medicaid nursing facility payment methodology that became effective March 1, 2016.