MedicaidPrior AuthMedium impact
[Ohio] Audaire Health Provider Portal
CareSource·OH · Oncology, Hematology, Pharmacy·Provider Bulletin
Effective date
Nov 1, 2025
We identified it
May 9, 2026
Summary
Effective November 1, 2025, CareSource Ohio requires providers administering CAR-T cell therapies to attest that they will submit clinical outcomes data to the Audaire Health provider portal. Prior authorization approvals for any of seven currently available CAR-T therapies will require this attestation. Providers must track and report outcomes at 3, 6, 12, and 24 months post-authorization through the Audaire portal or by phone/fax.
Action Required
By October 31, 2025: Billing and prior authorization teams must prepare for the new Audaire Health attestation requirement. (1) Update prior authorization workflows to include a mandatory attestation step confirming commitment to submit clinical outcomes data for all CAR-T therapy authorizations. (2) Ensure providers have access to Audaire portal training materials and contact information (www.audaire.com/portal; CareSourceOHRx@CareSource.com). (3) Create internal tracking system for outcomes submission deadlines (3, 6, 12, and 24 months from end of authorization period). (4) Brief clinical and billing staff on the seven affected HCPCS codes (Q2041, Q2042, Q2053, Q2054, Q2055, Q2056, Q2058). Failure to obtain attestation on or after November 1, 2025, will result in prior authorization denial for CAR-T therapies. Billing team must verify attestation is documented before processing claims for these procedures.