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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.


Will Student-Athlete Collectives Survive NIL Changes?

By July 2025 the landscape of student-athlete funding will look nothing like the current landscape, so preparing now is a must. If you are a student-athlete, the parent of a student-athlete, a university/college, or “booster”, it behooves you to understand these evolving issues.

Ohio's Recent Rule Changes to Administration of Immunizations, Outpatient Pharmacy Delivery, and Mobile Response Services

The Ohio Board of Pharmacy (“BOP”) and Ohio Department of Mental Health and Addiction Services (“OMHAS”) recently posted notices of Ohio Administrative Code rule changes related to the administration of immunizations (BOP), outpatient pharmacy delivery services (BOP), and mobile response and stabilization services (OMHAS).

HOA Construction Project Do’s and Don’ts

Local regulators can approve new construction, but if a resident contacts their homeowners association there may be trouble. Fences, yard alterations, and backyard decks do not have to be such a hassle and a point of conflict. Find out general Do’s and Don’ts to help HOA residents avoid issues in this article by BMD Partner Scott Heasley.

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.