MedicaidPrior AuthMedium impact
[Ohio] Level of Care and Prior Authorization Requirements for Medicaid Covered Nursing Facility (NF) Stays
CareSource·OH · Family Medicine, Internal Medicine, Geriatrics +1 more·Provider Bulletin
We identified it
Jun 13, 2026
Summary
CareSource Ohio Medicaid now requires prior authorization and specific level of care documentation for nursing facility admissions. This affects providers referring patients to nursing facilities under Ohio Medicaid coverage.
Action Required
Immediately: Billing team must obtain prior authorization before referring Ohio Medicaid patients to nursing facilities. Update referral processes to include level of care documentation requirements. Contact CareSource for authorization procedures. Failure to obtain prior auth will result in coverage denials for nursing facility stays.