CareSourceHigh ImpactPrior Auth

[Ohio] Temporary Waiver of Prior Authorization Requirements for Nursing Home Admissions from Hospital No Longer in Effect

Published May 9, 2026

AI Summary

CareSource Ohio has ended its temporary waiver that allowed nursing home admissions from hospitals without prior authorization. Prior authorization requirements for nursing home admissions from hospital settings are now back in effect.

Action Required

Immediately: Billing and discharge planning teams must obtain prior authorization before all nursing home admissions from hospital settings for CareSource Ohio members. Update discharge protocols to include prior auth step. Contact CareSource prior to discharge to avoid admission denials and patient placement issues.

Plan Types

Medicaid

States

OH

Specialties

hospitalist, family-medicine, internal-medicine, all-specialties