MedicaidCoverageMedium impact
[Ohio] 2026 Quality Enhancer Program
CareSource·OH · Family Medicine, Internal Medicine, OB-GYN +3 more·Quality Measures
Effective date
Jun 30, 2026
We identified it
May 9, 2026
Summary
CareSource is discontinuing the 2026 Quality Enhancer Program effective June 30, 2026. Providers must submit all claims for qualifying quality measures by that date to receive incentive payments. Final payments will be processed in Q4 2026. This affects multiple quality-related services across Medicaid, MyCare, and Next Gen/FIDE plans with varying incentive amounts ($10-$25 per measure).
Action Required
By June 30, 2026: Billing team must ensure all claims for qualifying quality measures (Diabetes A1c, Blood Pressure Control, Pediatric BMI, ePRAF, OB/GYN services, COA assessments, preventive screenings, and related codes referenced in the policy) are submitted within filing guidelines to capture final incentive payments. After June 30, 2026, no new incentive payments will be available for this program. Update billing staff on the sunset date and verify all pending quality measure claims are submitted timely. Monitor for final Q4 2026 payment processing. Contact CareSource Provider Services at 1-800-488-0134 (Ohio Medicaid/FIDE) or 1-833-230-2101 (Ohio Marketplace) with submission questions.