MedicaidBilling CodesMedium impact
Ohio Medicaid: Change to doula coordination of benefits
UnitedHealthcare·OH · OB-GYN, Family Medicine, General Practice·State news
Effective date
Jul 1, 2026
We identified it
Jul 2, 2026
Summary
Effective July 1, 2026, Ohio Medicaid changes doula services coordination of benefits rules. Commercial insurance plans now cover doula services, requiring Medicaid to be the payer of last resort. UnitedHealthcare Community Plan of Ohio will only pay for doula services after the member's primary commercial insurance pays first.
Action Required
By June 30, 2026: Billing team must update claims submission procedures for Ohio Medicaid members with dual insurance coverage. (1) Modify billing system to identify dual-insured patients with active commercial and Medicaid coverage. (2) Update encounter documentation to require front desk staff to collect BOTH primary insurance and Medicaid ID cards at each visit for doula service encounters. (3) Implement billing logic to submit doula service claims to primary commercial insurance first, then bill UnitedHealthcare Community Plan of Ohio for any remaining balance only after primary denial or partial payment. (4) Train front desk and billing staff on dual coverage verification process. Failure to bill primary insurance first may result in delayed payment or claim denials from UnitedHealthcare, as Medicaid is now explicitly secondary payer for doula services.