MedicaidAdministrativeMedium impact
OhioRISE enrollment and eligibility change
UnitedHealthcare·OH · Psychiatry, Family Medicine, Pediatrics·State news
Effective date
Jul 1, 2026
We identified it
Jun 13, 2026
Summary
Starting July 1, 2026, OhioRISE enrollment will be effective on the first day of the calendar month of eligibility, changing from the current enrollment timing. This change aligns with managed care program enrollment and reduces manual retro-enrollments for inpatient behavioral health admissions.
Action Required
Before July 1, 2026: Billing team must review and update workflows for behavioral health services that may span pre- and post-enrollment dates. Update billing system to align claim submissions with new OhioRISE enrollment timelines effective the first day of each month. Coordinate with managed care plans for CANS assessments completed prior to OhioRISE enrollment. Monitor for updates to the OhioRISE Mixed Services Protocol.