Providers Brace For State's Huge Behavioral Health Overhaul That State Says Hits This Weekend

Jun 29, 2018

On Sunday – the start of the state’s new fiscal year – the most complicated change the behavioral health system in Ohio has ever undergone officially kicks in. And some providers of addiction and mental illness treatment and counseling for low-income Ohioans are worried they won’t survive being moved into the Medicaid managed care system.

The five Medicaid managed care plans say they’ll pay “clean claims” in a week instead of 30 days for the first month. They’re also being required to use the same coverage policies and rates for the next year, and to honor prior authorizations and accept claims for six months after services are provided.

Ohio Mental Health and Addiction Services director Tracy Plouck says it’s understood some providers operate on slim margins. “Cash flow is a concern during this period of change, and so the precautions that Ohio Medicaid is putting in place with the managed care plans, I think, will help to position providers to weather the storm.”

Some providers said “rapid response teams” set up to field concerns were taking days and sometimes weeks to respond, but Medicaid’s director says those reports have been difficult to investigate.