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This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and universities.

Rule 5160-1-03 | Medicaid: relationship to the children with medical handicaps program under Title V of the Social Security Act.


(A) For persons eligible under both medicaid, administered by the Ohio department of medicaid (ODM), and the children with medical handicaps (CMH) program, administered by the Ohio department of health (ODH), medicaid is the first payer of health care claims (unless a consumer has third party insurance and/or is a medicare beneficiary, then rules 5160-1-05 and 5160-1-08 of the Administrative Code regarding coordination of benefits with a primary payer apply) and its payment constitutes payment in full.

(B) As long as eligibility has been established under the CMH program and services were authorized by the CMH, medicaid providers shall submit all claims for services to persons eligible under both medicaid and the CMH program first to ODM for adjudication under the medicaid program (unless there is a primary payer as described in paragraph (A) of this rule). .

Supplemental Information

Authorized By: 5164.02
Amplifies: 5164.02
Five Year Review Date: 11/2/2019
Prior Effective Dates: 4/7/1977, 12/21/1977, 12/30/1977, 7/1/1980, 3/5/1982, 10/1/1987, 7/7/2002, 9/1/2007