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This document outlines the updated definitions and principles related to medical necessity under the Medicaid program in Ohio. The rule establishes criteria for determining medical necessity, clarifies roles in service provision, and includes revisions regarding preventive services and adverse health conditions.

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Read the complete text of rule 5160-1-01 to understand its context and requirements.

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Who needs rule 5160-1-01?

01

Individuals applying for Medicaid services.

02

Healthcare providers who need to comply with state regulations.

03

Administrative staff responsible for processing Medicaid applications.

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What is rule 5160-1-01?

Rule 5160-1-01 is a regulation that outlines specific procedures and requirements for reporting certain information related to healthcare services under state Medicaid programs.

Who is required to file rule 5160-1-01?

Providers of healthcare services that participate in Medicaid programs are required to file rule 5160-1-01 to ensure compliance with regulatory standards.

How to fill out rule 5160-1-01?

To fill out rule 5160-1-01, providers must gather the required data, complete the designated forms accurately, and submit them through the specified channels as outlined in the rule.

What is the purpose of rule 5160-1-01?

The purpose of rule 5160-1-01 is to ensure accountability and transparency in the reporting process of healthcare services provided under the Medicaid program.

What information must be reported on rule 5160-1-01?

Information that must be reported includes service details, provider identification, patient data, and compliance metrics as required by the Medicaid regulations.

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