OhioRISE enrollment and eligibility change
AI Summary
Starting July 1, 2026, OhioRISE enrollment will be effective on the first day of the calendar month of eligibility, rather than the actual eligibility date. This change aligns with managed care enrollment processes and reduces manual retro-enrollments for inpatient behavioral health admissions.
Action Required
By July 1, 2026: Billing team must review and update workflows for services spanning pre- and post-enrollment dates. Update billing system to align with new OhioRISE enrollment timelines where enrollment begins first day of eligibility month. Coordinate with managed care plans for CANS assessments completed prior to OhioRISE enrollment. Monitor for updates to OhioRISE Mixed Services Protocol reflecting this rule change.
Plan Types
Medicaid
States
OH
Specialties
psychiatry, pediatrics