Ohio Department of Medicaid (ODM) is pleased to announce the rollout of substantial reimbursement rate increases effective January 1, 2024. As part of Governor Mike DeWine’s commitment to making sure every Ohioan receives quality care, and with the support of the General Assembly, these rate increases, outlined in the Fiscal Year 2024-2025 operating budget bill, support providers as they continue delivering the highest level of care for Ohio’s residents.
The rate increases are historic in nature, totaling approximately $3.4 billion per year across a network of more than 200,000 active providers. In July, ODM implemented nursing facility rate increases. In addition, other provider types benefiting from the rate increases going into effect in January include:
|
These new rates apply to January 1, 2024, dates of service and beyond. ODM reimburses all services based on the date of service, not the date the provider bills the service. More information on this change is available in our FAQ posted here: https://medicaid.ohio.gov/about-us/budget/budget.
Copies of budget stakeholder briefings and provider rate trackers are available here on the ODM budget webpage. For additional questions, providers can contact the ODM Integrated Helpdesk (IHD) at 800-686-1516 or IHD@medicaid.ohio.gov. Representatives are available 8a.m.-4:30 p.m. Eastern time Monday – Friday.
Return to Top
underpayment of nursing facility fee-for-service reprocessed the majority of these nursing facility fee-for-service claims with correct pricing. In January, ODM will finish reprocessing and correcting nursing facility claims that we paid incorrectly due to a defect on the Share of Cost/Patient Liability.
 |
|
What action do providers need to take?
Providers do not need to take action on this issue. ODM is reprocessing adjustments on behalf of providers.
|
 |
|
If you have any questions or concerns, please contact Ohio Medicaid’s Integrated Helpdesk at 800‐686‐1516 or email IHD@medicaid.ohio.gov. Representatives are available 8 a.m.‐4:30 p.m. Eastern time Monday‐Friday.
|
Return to Top
Ohio Department of Medicaid’s OhioRISE program is a specialized managed care program for youth with complex behavioral health and multisystem needs. If you have patients or families that need more information about the OhioRISE program, point them to the Resources for Members and Families webpage which has everything they need to know!
Who can benefit from the OhioRISE program?
- Have multiple needs that result from behavioral health challenges.
- Have multisystem needs or are at risk for deeper system involvement.
- Are at risk of out-of-home placement or are returning to their families from out-of-home placement.
Who is eligible for the OhioRISE program?
Children and youth who may be eligible for OhioRISE must meet each of the following criteria:
Return to Top
|
