Posted by Behavioral Health Billing Solutions, LLC.
It’s one week past go live of the Managed Care Carve in and it’s been a busy one. It’s a mixed bag of providers without an EHR, without a clearing house, providers not registered with Medicaid and an executive order that perhaps hasn’t been fully conveyed to the staff enrolling providers or there’s a misunderstanding on when it does or doesn’t apply.
We have been receiving calls and emails daily from clients or contacts who are trying to get through each painful step. The week started with an emergency ruling by Governor Kasich on June 29th that allows behavioral health practitioners who have had certain past convictions to be enrolled as Medicaid providers, as part of the Ohio Department of Medicaid’s behavioral health redesign. Please click here for the executive order. Click here for the tiered offenses and here for the referenced rule.
Considering that the latest from OhioMAS touts a program held in early June about Peer Recovery providers, the most highly impacted by the criminal background issue is definitely something to think about. Their publication is available here.
However, we’ve received reports of providers that were originally denied and yet when they contacted Medicaid after the emergency ruling, they were still denied the ability to be a Medicaid provider. And according to our contact, the offense was one listed as part of the ruling. If you have a similar situation, please feel free to reach out to firstname.lastname@example.org.
Other big news was the announcement of a new Director of OhioMAS on Friday. Tracey Plouck announced she is leaving to go to the private sector and Dr. Mark Hurst is her replacement. Please see the email notification sent out late Friday.
Today the Governor’s Office is announcing the upcoming appointment of Dr. Mark Hurst as OhioMHAS Director. Most of you know Dr. Hurst, who has served as our medical director since early in the Kasich Administration.
Thank you for working constructively with OhioMHAS over the years. I’m confident that Dr. Hurst’s leadership and demeanor will have a very positive impact on the ADAMH/State relationship and on our collective forward progress. Nicole Marx will continue to serve as Assistant to the Director, and Jim Lapczynski will continue to serve as your point of escalation if you’re not getting a returned phone call, etc. from a member of the OhioMHAS team.
In the next budget cycle and with the change of Administration, do whatever you can to advocate for continued health care for Ohioans who need it. Your efforts there are imperative.
I anticipate that I’ll be seeing many of you again and look forward to that.
Tracy J. Plouck, Director
Ohio Department of Mental Health & Addiction Services
30 E. Broad St., 36th Fl.
Columbus, OH 43215
Other notable news includes any prior authorization obtained through the MITS portal will be honored by the Managed Care companies, however, you will need a different authorization number. Their systems are not compatible with the authorization number format issued by MITS.
IF you have authorizations obtained through MITS into July, be sure to contact the MCO (if they haven’t reached out to you) to obtain the new one if they have not contacted you directly. The latest update to the MCO resource guide including contact info, can be found here.
Keep in mind, if you are a small to medium agency looking for an EHR, we may have an opportunity for you to get up and functional on a proven EHR in a fraction of the normal time needed to do so. Give us a call or email if you want to hear more information about the program.