Medicaid provider works online

Visit this page often to find current network notices, current and previous issues of our New Horizon Ohio Medicaid provider newsletter, and updates to our prior authorization processes.

Important information from the Ohio Department of Medicaid

Medicaid fraud warning: Criminals are targeting Medicaid recipients for sensitive, personal, and financial information. If you get a call, text, or email about Medicaid benefits that ask for Social Security Number, payment, bank, debit, or credit card information, do not respond. The communications are not from the State of Ohio or any agency. Instead, report it to the Ohio Attorney General by calling 800-282-0515 or visiting his website .

Network notices

2025

Enteral claims billing update

Medicaid Claim Denials Due to EVV Non-Compliance – Private Duty Nursing

Secure Email Update

Medicaid claim denials due to EVV non-compliance

Notice of change to preauthorization requirements for medical services -notification list (PAL) update

Medicaid Quality Plus Notification/Incorrect Mailing

Hospice Nursing Facility Room and Board (HCPC T2046)

Retroactive Member Eligibility Termination Issue

Annual provider satisfaction survey

Humana out-of-network claims payment policy update

Temporary waiver of prior authorization requirements for nursing home admissions from hospitals

Duplicate Provider Check Payments/Error – Retracting Funds Bank Account

2024

2024 Managed Care Plan Diabetes Initiatives

Electronic visit verification compliance

Prior authorization management for HealthVine members

Home health and private duty nursing training

Timely Filing Extension Notice

Diabetes Self-Management Education (DSME) Benefits for Ohio Medicaid Members

Claim edit change effective May 9, 2024

All Plan PRAF Quality Enhance Incentive Payment Sustainability Communication form 2024

All Plan PRAF Technical Assistance Intervention Package Sustainability Communication form 2024

Ohio Provider Notice Coverage of DexCom

Ohio Provider Notice-Enhanced Reimbursement for diabetes self-management education March 19, 2024

Medicaid Agreement Revalidations in the Provider Network Management Module

2023

Diabetes Self-Management Education (DSME) Quick Reference Guide – For Providers

Enhanced Reimbursement for Diabetes Self-Management Education

Coverage of DexCom and FreeStyle Continuous Glucose Monitors (CGMs) via the Medical / Durable Medical Equipment Benefit

Quality Enhancer Incentive Program Electronic Pregnancy Risk Assessment Form (ePRAF)

Technical Assistance Intervention Package Electronic Pregnancy Risk Assessment Form (ePRAF)

Electronic visit verification (EVV) communication

Food and Drug Administration MedWatch – HAMILTON-C1, T1, and MR-1 ventilators recalled for leaks and short circuits

Provider Network Notification – Provider Network Management (PNM) integration delayed

Provider Network Notification Authorization Process Update

Provider Network Notification – Provider network management

Provider Network Notification – OhioRISE referral mailbox email address

Provider Network Notification - SUD Residential Providers – Effective October 27, 2023

Public health emergency (PHE) end date and preadmission screening and resident review (PASRR) impact – effective April 20, 2023

Use your secure Availity account to submit transplant inpatient prior authorizations requests – effective Mar. 27, 2023

Claims filing updates – effective Feb. 9, 2023

Member ID card updates – effective Feb. 1, 2023

Newborn enrollment eligibility

2022

December update: ODM go-live date changes update

Humana Healthy Horizons in Ohio Provider Newsletter

2025

New Horizon Ohio Medicaid Provider Newsletter – Volume II

Humana Healthy Horizons in Ohio Provider Newsletter Archive

New Horizon Ohio Medicaid Provider Newsletter – Volume I

Additional information

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Ohio Medicaid

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