MedicaidAdministrativeMedium impact
OhioRISE enrollment and eligibility change
UnitedHealthcare·OH · Psychiatry, Pediatrics·State news
Effective date
Jul 1, 2026
We identified it
Apr 1, 2026
Summary
Starting July 1, 2026, OhioRISE enrollment will be effective on the first day of the calendar month of eligibility, instead of the previous 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 services that may span pre- and post-enrollment dates. Submit claims in alignment with the new OhioRISE enrollment timeline starting the first day of the eligibility month. Coordinate with managed care plans for CANS assessments completed prior to OhioRISE enrollment. Monitor for updates to the OhioRISE Mixed Services Protocol.