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Since the Ohio Department of Medicaid's Feb. 1 go-live of the Next Generation managed care plans, new Electronic Data Interchange and Fiscal Intermediary, OHA has been working closely with member hospitals, ODM and the Medicaid MCOs to identify and help resolve issues. This Finance News item contains an OHA-developed issues log that will be updated to inform members of outstanding issues and resolutions. Note that this is not an all-inclusive list of issues and was created to help members track known issues as ODM does not publish an issues list (i.e., this issues log has no affiliation to ODM and was…

CMS on  April 5, 2023 issued the “Medicare Program; Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly” final rule which included requirements and clarifications relating to Medicare Advantage coverage criteria for basic benefits, use of prior authorization, and the annual review of utilization management tools. The new regulatory provisions are applicable to coverage beginning Jan. 1, 2024.Since the issuance of this rule, CMS has received questions about the application of these rules once they are effective. In this memo,…

SAMHSA Prevention Day, held on Jan. 29, convened prevention advocates and professionals nationwide to discuss advancements and future opportunities in substance use prevention. Dr. Miriam Delphin-Rittmon announced updates to the Overdose Prevention and Response Toolkit, which now offers guidance on opioid overdose reversal medications, addresses stimulant overdoses and includes population-specific information. 

Join the Ohio Society of Health Care Risk Managers and the Society for Ohio Health Care Attorneys members, as well as attorneys and risk management professionals, converging on March 15 for the in-person spring conference. Gain an understanding of key risk management and legal issues currently affecting hospitals. The conference will explore topics like AI in health care, optimizing risk-defense counsel relationships, legislative updates and more. Earn CPHRM and CLE continuing education credits while networking with peers. Click here to learn more and register.