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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.


Compounding GLP-1 Drugs - Recent Updates

Recent guidance from the Ohio Board of Pharmacy (“BOP”) indicates that providers should generally use the FDA approved GLP-1 drug, rather than a non-FDA approved compounded version of the medication. Importantly, if a GLP-1 drug is commercially available, it cannot be copied through compounding. Currently, compounded copies of Tirzepatide and Semaglutide are not permitted.

Top Compliance Risks for Ohio Med-Spas in 2025

The Ohio Board of Pharmacy has increased inspections of med-spas holding Terminal Distributor of Dangerous Drugs (TDDD) licenses, with many facing enforcement actions in 2025. Common issues include purchasing from unlicensed distributors, improper drug storage, inadequate recordkeeping, and insufficient prescriber oversight. Understanding these risks and maintaining compliance can help protect your practice from penalties and license suspension.

Pre and Postnuptial Agreements | Necessary, Maybe, What Happened to Forever?

Both Florida and Ohio now allow clients to enter into a prenuptial or postnuptial agreement prior to marriage or after marriage (Ohio previously did not allow postnuptial agreements). Both documents have statutory guidelines that must be followed in terms of execution and financial disclosure.

DHS Ends All Employment Authorization Auto-Extensions

Effective October 30, 2025, DHS ends all automatic work authorization renewals. The 540-day extension applies only to renewals filed before this date, and there is no grace period for expired EADs filed on or after October 30. Employers must audit EADs, train staff, ensure I-9 compliance, and plan for work authorization gaps. Penalties for noncompliance can be severe.

CMS’s Rural Health Funding Announcement

CMS has announced a $50 billion Rural Health Transformation (RHT) Program to improve healthcare access, quality, and outcomes in rural communities. All states are eligible to apply for funding by November 5, 2025. Half of the funds will be distributed equally, with the remainder based on state-specific factors. The program supports evidence-based initiatives, workforce recruitment, and access to treatment services, with awards assessed annually