MedicaidAdministrativeMedium impact
[Ohio] Doula services and coordination of benefits (COB)
Anthem BCBS·OH · OB-GYN, Family Medicine, General Practice·Provider Bulletin
Effective date
Jul 1, 2026
We identified it
May 27, 2026
Summary
Effective July 1, 2026, Ohio Medicaid (Anthem) is implementing Coordination of Benefits (COB) requirements for doula services. Doulas must now bill commercial insurance first before billing Medicaid, as federal rules require Medicaid to be the payer of last resort. This change aligns with recent commercial insurance coverage of doula services.
Action Required
By June 30, 2026: Billing team must update all doula service claim submission workflows to verify and bill primary commercial insurance BEFORE submitting claims to Ohio Medicaid. Update billing software rules and provider instructions to reflect COB requirements. Train billing staff on the new COB process for doula services. Verify patient insurance information at check-in to identify primary coverage. Failure to bill primary insurance first will result in claim denials or recoupment from Medicaid.