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June 2024 Managed Care Plan Updates

This past month, the managed care plans have published updates on events and policy changes impacting their organizations.

Ohio Department of Medicaid: 

The Ohio Department of Medicaid (ODM), in partnership with the State of Ohio’s Child and Adolescent Behavioral Health Center of Excellence at Case Western Reserve University, (COE) is helping to launch and expand access to a critical mental health service in 59 counties, which results in a total of 76 out of the 88 counties in Ohio having access to an Intensive Home-Based Treatment program.  ODM authorized $10 million to support a much-needed mental health service called Intensive Home-Based Treatment (IHBT), to learn more click here.

 

AmeriHealth Caritas: 

Removal of prior authorization for certain services is part of AmeriHealth Caritas’ continued efforts to make the prior authorization process more efficient and transparent. Their goal is to enhance the provider experience by making it easier for providers to navigate the prior authorization process, helping ensure timely member access to necessary services.

Beginning 6/22/24, the procedure codes listed here do not require prior authorization.

 

CareSource: 

Caresource recognizes that it’s their responsibility to provide resources that support providers’ and other community partners’ ability to deliver effective and culturally competent care. The CareSource Health Equity webpage includes links to education opportunities and press releases that share the difference they are making in local communities.

 

Molina Healthcare:  

Molina is reminding providers that they are prohibited from balance billing members for covered services other than the member’s applicable copayment, coinsurance or deductible amounts. Covered services include health care services and supplies, including emergency services provided to members that are medically necessary and covered by Molina as a member benefit. To read more on this, click here.

 

United Healthcare:

Changes are coming soon to United Healthcare’s Provider Portal access. If you use the portal, you’ll need to update your One Healthcare ID authentication options to retain access. Click here to learn more.

United Healthcare has new and enhanced claims submission process features. Click here to learn more.

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