This past month, the managed care plans have published updates on events and policy changes impacting their organizations.
- Public Health Emergency Ending – Updates to Benefits and Rates: Effective May 11, 2023, the Department of Health and Human Services (HHS) plans to end the Public Health Emergency for COVID-19. Beginning May 12, 2023, CareSource will remove certain benefit such as telehealth and expansion of molecular diagnostic testing for influenza. Also CareSource will be implementing some rate changes that were implemented during the pandemic to support members and providers. Click here to review all the changes being made.
- ODM EDI Claims and Bridge Payments for Providers: As part of the Next Generation program transition, ODM developed extensive monitoring and a variety of contingency plans. Specifically, Ohio Medicaid is now initiating extra measures to minimize provider disruption and ensure payment continuity. ODM is taking two steps to assist trading partners and providers with the February 1 and Ohio Medicaid Enterprise System (OMES) transitions: 1) Temporary Redirection of Electronic Data Interchange (EDI) Claims from OMES to the Managed Care Entities (MCEs) and 2) Temporary Bridge Payments. Click here to review this full update.