The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.
Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.
| The Academy Weekly Headlines from 2 Weeks Ago|
ODM delays Next Gen Medicaid managed care
The Ohio Department of Medicaid delayed the final phase of its Next Generation Medicaid Managed Care. OMES was scheduled to launch on December 1, which would have incorporated the billing and prior authorizations for traditional and Group VIII Medicaid managed care (not MyCare Ohio). According to ODM, stakeholder concerns has caused them to hit the pause button and do a more phased-in approach beginning February 1. The current plan is as follows:
Providers should continue to do business as they do today. However, the transition for Medicaid members will vary depending on the managed care plan they are enrolled in and their choice for next generation enrollment:
- On February 1, 2023, ODM will launch the Next Generation managed care plans and program requirements, including exciting improvements that will support members in accessing the healthcare services and supports they need. ODM will also implement the new Electronic Data Interchange (EDI), increasing transparency and visibility of member care and services.
- Subsequently, ODM will fully launch OMES modules to provide streamlined processes for claims, prior authorizations, and other administrative tasks for providers.
We will keep you updated as we learn more.
- Managed care members that have not made an active plan selection will continue receiving healthcare coverage through their current managed care plan.
- Paramount Advantage members will continue receiving healthcare coverage through Paramount Advantage until February 1. At that time Anthem will be their Next Generation managed care plan, unless they selected a different plan.
- Managed care members that selected a new Next Generation managed care plan will begin receiving services from that plan February 1.
- Managed care members that selected a different continuing plan, such as CareSource Ohio, Inc., Buckeye Health Plan, Molina Healthcare of Ohio, Inc., or United Healthcare Community Plan of Ohio, Inc., from their current plan will begin receiving services from that plan on December 1.
- Individuals who are newly eligible for managed care, those who are currently in Medicaid fee-for-service but not enrolled with a managed care plan, and those with a gap in eligibility of 91+ days will receive care paid for through Medicaid fee-for-service until February 1, 2023 when they are transitioned to an Ohio Medicaid Next Generation plan.
Email no longer necessary for SRIs
The Ohio Department of Health developed a work around to their IT limitations related to the updated information necessary for SRIs. That process involved providers emailing the additional information on new forms. ODH has since updated their system to allow for the forms to be attached to the report. From ODH: In an effort to make SRI submission more streamlined for providers, we have updated the submission directions for the provider to submit an attachment with the initial SRI. Providers will no longer e-mail the SRI Initial Form to ODH. Providers are required to upload the SRI Initial Form directly into EIDC by following the attached instructions. (Click here to download instructions. The initial form can be downloaded by clicking here. The final form is available here.)
ODH waives NATCEP hours requirement
The Ohio Department of Health waived the maximum hours of training allowable by a supplemental instructor within an approved NATCEP (rule 371-18-09(l)). According to ODH, this was the quickest method to allow more flexibility for NATCEPs. ODH has said they will update the rules in the future; however, current priorities are making it difficult to correct the rules, hence the waiver. Please click here to view the Director's Journal Entry that waives the rule for more details.
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