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South Central / Southeast Region
January 6, 2023
January Managed Care Plan Updates

This past month, CareSource and Buckey Health Plan have published updates on events and policy changes impacting their organizations.

CareSource Update

  • Prior Authorization Requirement for Non-Participating Laboratory Services: Effective January 10, 2023, CareSource will enforce our prior authorization requirement for non-participating laboratories.  If a non-participating laboratory does not obtain a prior authorization claim will not be obtained. CareSource recommends patients be referred to in-network, participating laboratories. Click here to review the policy update.

Buckeye Health Plan Update

  • Increase Payments for Medicaid CANS Assessments:  Effective for dates of service January 1, 2023, and after, ODM will be increasing the payment rate for CANS assessments. The updated rates will be reflected in the revised Appendix to OAC rule 5160-27-03, the Medicaid Behavioral Health Provider Manual and the OhioRISE Provider Enrollment and Billing Guidance prior to January 1, 2023. Click here to review the update.
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