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Ohio Medicaid Extends Timely Filing Deadline Until 2025

Client Alert

The Ohio Department of Medicaid (ODM) recently announced that it is extending its timely filing deadline to February 28, 2025. According to ODM, roughly 2% of providers have contract issues preventing them from meeting the previous timely filing deadline of December 1, 2024.

Before March 1, 2025, providers need to:

  • Submit as many claims as they can now to avoid additional manual work and time required to process them after the deadline. If a data fix or system configuration is required to properly adjudicate the claim, ODM will adjust claims successfully received by the system even if the timely filing deadline has passed.
  • Review Provider Network Management (PNM) data associated with claims denied for a contract or affiliation related issue to make sure it is correct. If the PNM data is correct, but a provider received a denial indicating a contract or an affiliation issue, report these issues to ODM’s Integrated Helpdesk (IHD).

Note that even though ODM extended the timely filing requirements, claims submitted after the standard 365-day limit are still subject to post-payment review. ODM may look at evidence of system submissions issues when deciding whether to reverse payment. Evidence may include review of past IHD call logs to verify that providers attempted to troubleshoot their issue.

Providers are encouraged to reach out to the ODM IHD with questions.

If you have questions about the extended deadline and what that means for your organization, please contact Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com.


New Ohio Recovery Housing Rules Take Effect January 1, 2025

Ohio’s new recovery housing rules, effective January 1, 2025, require certified community behavioral health providers to refer clients only to accredited recovery housing residences listed on the statewide registry.

SCOTUS to Weigh In on Medicaid Beneficiaries’ Right to Choose their Provider

The U.S. Supreme Court will hear arguments this spring on whether Medicaid beneficiaries have an enforceable right to choose their healthcare providers without state interference, as outlined in Section 1902(a)(23) of the Social Security Act. This case stems from a South Carolina petition challenging a Fourth Circuit ruling that blocked the state from terminating Planned Parenthood’s Medicaid provider agreement.

I Went to Bed and the Rules Changed: the Corporate Transparency Act is Back on Hold

The United States Court of Appeals for the Fifth Circuit ordered on December 26, 2024 that in an effort to “preserve the constitutional status quo” while it considered the Federal Government’s appeal, it vacated the prior order for a stay of the nationwide injunction pending appeal entered on December 23, 2024, and reinstated the preliminary injunction enjoining enforcement of the CTA and its corresponding Reporting Rule.

Telemedicine Flexibilities Extended to March 31, 2025

The American Relief Act of 2025 extends key telehealth flexibilities through March 31, 2025, originally enacted during the COVID-19 Public Health Emergency (PHE). These flexibilities remove geographic and originating site restrictions for Medicare patients, expand the list of qualified practitioners, and allow for audio-only services and telehealth mental health care without in-person requirements. Although this extension is temporary, it provides continued access to essential healthcare services. Congress will need to pass permanent legislation to solidify these changes beyond March 2025.

Corporate Transparency Act Is Back in Effect: Are You Ready?

On December 23, 2024, the Fifth Circuit Court of Appeals reinstated the filing requirements under the Corporate Transparency Act (CTA), overturning a prior injunction. Businesses now have updated deadlines to file initial beneficial ownership information reports with the Financial Crimes Enforcement Network (FinCEN), based on their registration date. Affected companies must comply with these new deadlines, which vary depending on when the company was created or registered.