Ohio Medicaid Seeks Behavioral Health & Hospital Utilization Management Program

On February 9, 2017, the Ohio Department of Medicaid (ODM) began a competitive procurement process for a statewide quality and hospital utilization control program. The program includes responsibilities for providing prior authorization for the state’s new Behavioral Health Redesign services. The selected vendor will implement and manage the program, which will monitor utilization and the quality of services provided across the continuum of care to Ohio Medicaid consumers. Further, the vendor will help ODM migrate Behavioral Health Redesign services from a fee-for-service (FFS) reimbursement methodology to a managed care environment in the future.

The quality and hospital . . .