Ohio Adds Utilization Controls on Community Mental Health; Health Care Excel Wins Prior Authorization Contract

Share On July 25, 2011, Ohio Medicaid selected Health Care Excel, Inc. for a $1.3 million one-one year contract to provide prior authorization services through June 30, 2012. This is part of a range of utilization controls on community-based mental health services that were effective July 1, 2011. The new controls include tiered rates for community psychiatric support treatment (CPST) services, limits on billing V-codes, prior authorization for CPST services and Medicaid partial hospitalization beyond the benefit limit; and a defined benefit package. The utilization controls were outlined by ODMH in “Ohio Department of Mental Health . . .