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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.


CMS and Ohio Ramp Up Fraud Enforcement in Home Health and Hospice

CMS and Ohio have launched sweeping new fraud prevention initiatives targeting home health and hospice providers, signaling a period of heightened scrutiny for enrollment, billing, documentation, and EVV compliance. While aimed at combating fraud, these measures also create significant operational and due process risks for compliant agencies, making proactive compliance programs, auditing, and governance more important than ever.

MYTH BUSTER: Can a New Chiropractor Bill Under An Established Chiropractor’s NPI?

Many chiropractic practices mistakenly believe a newly hired chiropractor can bill under an established chiropractor’s NPI while waiting for credentialing approval. In most cases, this is not permitted. Claims should be submitted under the NPI of the chiropractor who actually rendered the service to avoid compliance risks, including potential False Claims Act exposure. This article outlines key billing rules, common exceptions, and practical compliance tips for chiropractic practices.

RNs and APRNs Take Note: Ohio Board of Nursing Mandates a New CE Reporting Period

Ohio’s Board of Nursing has updated the continuing education reporting period for RNs and APRNs. Beginning March 26, 2026, CE credits must be completed between July 1 and June 30 of odd-numbered years, replacing the previous November to October timeframe.

Ohio Med Spas: Peptide Do's and Do Not's

Recent guidance from the Ohio Board of Pharmacy outlines key compliance requirements for med spas using peptides. While some peptide drugs are FDA approved, others are not or cannot be compounded. Med spa operators should ensure they source medications from licensed suppliers, avoid non-approved or “research use only” products, and follow all compounding and storage regulations to maintain compliance and avoid enforcement actions.

Substance Use Disorder Providers: 42 CFR Part 2 Now Enforceable

Updates to 42 CFR Part 2 are now enforceable, bringing significant changes to how substance use disorder (SUD) records are handled. The Final Rule aligns Part 2 more closely with HIPAA, introduces updated penalties, allows a single patient consent for treatment, payment, and operations, and adds new requirements for Notices of Privacy Practices. It also creates a formal definition of SUD counseling notes and imposes strict consent requirements for their use and disclosure. Providers should review and update policies to ensure compliance.