On Jan. 31, the Ohio Department of Mental Health and Addiction Services (OhioMHAS) and the Ohio Department of Medicaid (ODM) released updated resources for the Medicaid Behavioral Health Redesign. These documents can be found on the Behavioral Health Redesign website here. The resources include:
Drafts of Ohio Administrative Code Rules for Behavioral Health Redesign
Draft versions of the Ohio Department of Medicaid Ohio Administrative Code (OAC) rules regarding Medicaid behavioral health service definitions, coverage, payment policy, and recipient and provider eligibility are posted HERE. The ODM rules also propose consolidating Medicaid MH and SUD rules into a single OAC chapter. In addition to the regular Common Sense Initiative (CSI) and Joint Committee Agency Rule Review (JCARR) public rulemaking process, ODM will also accept informal stakeholder input through close of business on Monday, Feb. 20. Please submit written comments to this email address: BH-Enroll@Medicaid.Ohio.Gov.
The Ohio Department of Mental Health and Addiction Services (OhioMHAS) will be releasing updated/new Ohio Administrative Code rules via the CSI and the JCARR public processes. The OhioMHAS specific rules also support the reframing of OhioMHAS certification with a focus on recognition of practitioner scopes of practice as recognized by the professional regulatory boards, as well as on patient health, welfare and safety standards and finalizing merging of the ODADAS and ODMH regulatory frameworks into a single chapter. The OhioMHAS rules may be found HERE.
Behavioral Health Provider Manual
The latest draft of the BH provider manual contains critical information for provider staff regarding service definitions, units, eligible providers, billing codes, modifiers, payment rates, etc. The manual may be found HERE.
IT System Guidance
ODM staff have developed several documents to assist provider agencies in making needed modifications to their information technology systems to be in compliance with the revised Medicaid behavioral health benefit package. The resources include several very detailed spreadsheets and documents providing specifications and guidance. The IT System Guidance documents may be found HERE under the “IT Resources” heading.
Specifically, these documents include:
· Rendering/Supervising/Ordering claim field specifications
· Crosswalk showing the interactions of procedure codes
· Services allowed in conjunction with ACT/IHBT Diagnosis code groups
· Services billable to Medicare
· MITS System edits/audits