CareSourceMedium ImpactPrior Auth

[Ohio] Level of Care and Prior Authorization Requirements for Medicaid Covered Nursing Facility (NF) Stays

Published May 9, 2026

AI Summary

CareSource has updated level of care and prior authorization requirements for Medicaid-covered nursing facility stays in Ohio. This affects billing and authorization processes for patients requiring skilled nursing facility placement.

Action Required

Immediately: Billing team must review updated prior authorization requirements for Medicaid nursing facility stays. Update authorization workflows to comply with new level of care criteria. Ensure proper documentation is obtained before submitting claims for CareSource Medicaid members requiring nursing facility placement.

Plan Types

Medicaid

States

OH

Specialties

family-medicine, internal-medicine, geriatrics, hospitalist, general-practice