Ohio BH Redesign Updates!

Ohio’s Behavioral Health (BH) Redesign DID NOT go into effect on July 1, 2017, in deference to the legislative budget process. The Ohio Department of Medicaid (ODM) and the Ohio Department of Mental Health and Addiction Services (OhioMHAS) provided the following updated timeline for behavioral health redesign implementation resulting from the final version of Ohio’s 2018-2019 biennial budget, Amended Substitute House Bill 49:

Aug. 1, 2017:

 

o   Ohio hospitals may begin delivering and billing for Medicaid behavioral health outpatient services using the new code set. This initiative is intended to increase access to behavioral health services for Ohioans in need, especially for children and multi-system youth. Early implementation by hospitals is possible because the Medicaid claims system for hospitals is separate from that used by community BH providers who are certified by OhioMHAS. This initiative is authorized by Ohio Administrative Code Rule 5160-2-75 which was reviewed by the Joint Committee on Agency Rule Review (JCARR) on July 17 for an Aug. 1, 2017 effective date. Click HERE for more details.

 

Oct. 1, 2017:

 

o   ODM rules for Medicaid community BH services will be final filed for a Jan. 1, 2018 effective date. In addition, final versions of provider manuals, coding sets and workbooks regarding the new BH code set will be publicly available. The most up-to-date versions of these documents are currently posted HERE.

 

Jan. 1, 2018:

 

o   Providers of Medicaid community behavioral health services (provider types 84 and 95 in MITS) will begin to render and bill for services using the new behavioral health coding structure and benefit package.

o   For clients enrolled in Medicaid managed care, behavioral health services will be “carved in” to Ohio Medicaid managed care plans and services will be billed directly to the individual’s plan.

o   For clients who are not enrolled in a managed care plan, services will continue to be paid through the Ohio Medicaid fee-for-service system (MITS).

 

For more information on Behavioral Health Medicaid Redesign, visit http://bh.medicaid.ohio.gov. We value your feedback and questions. 

Reference:

E. Wandersleben, e-mail communication, July 26, 2017