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** Please be advised that the Integrated Helpdesk will be closed on June 19, 2026, in observance of Juneteenth Day. The Pharmacy and Sandata EVV help desks are excluded from the Holiday closure and will remain open. 

 

Notice: Qualified Entity/Presumptive Eligibility Portal Maintenance

Ohio Benefits will conduct planned maintenance activity this Friday, June 12 from 6:00 p.m. to Monday, June 15 at 6:00 a.m.

During this time, the Presumptive Eligibility and Deemed Newborn Portal will be unavailable. Should the maintenance window complete sooner, a message will be posted here.

 

UPDATED State Fiscal Year-End Claims Submission and Provider Payments

The Ohio Department of Medicaid anticipates issuing final provider payments for SFY 2026 on Thursday, June 25. Medicaid provider claims not processed before 12 p.m., Friday, June 19, will be held for processing until the state’s accounting system, also known as the Ohio Administrative Knowledge System (OAKS), is reactivated for state fiscal year (SFY) 2027 (beginning July 1).

Ohio Medicaid anticipates issuing the first payment of SFY 2027 to providers on July 7 or July 8. Please note, due to fiscal year-end processing and the reactivation of OAKS, coupled with the July 4th holiday, the first payment of SFY 2027 may not be made as anticipated.

 

Important: Moratorium on Enrollment of Home Health and Hospice Providers

Effective May 14, 2026 through November 14, 2026: In accordance with CMS-6101-N and 42 CFR 455.470, the Ohio Department of Medicaid (ODM) is implementing a moratorium on the enrollment of Home Health and Hospice providers. During this period, ODM will not accept new Medicaid enrollment applications for Hospice or Home Health Agencies, Waiver Individuals and Organizations, Private Duty Nurses, Personal Care Aides and Home Care Attendants.  In accordance with OAC 5160-1-17.6(G)(28), any application for the following provider types submitted prior to May 14, 2026, but not yet processed by the Department will be denied.  Impacted applicants will receive notice of the application denial. Applicants are welcome to reapply if and when the moratorium is no longer in effect. Existing enrolled providers of these types may continue to operate however no new service locations will be added during this time. Demographic changes and revalidations will still be processed.

  • 16 – Other Accredited Home Health Agency
  • 25 – Non-Agency Personal Care Aide
  • 26 – Non-Agency Home Care Attendant
  • 38 – Private Duty Nurse (Registered Nurse and Licensed Practical Nurse)
  • 44 – Hospice
  • 45 – Waivered Services Organization
  • 55 – Waivered Services Individual
  • 60 – Medicare Certified Home Health Agency 

 

Enhancing Efficiency and Access with the PNM System

The Provider Network Management (PNM) system is the single source of truth for Ohio Medicaid provider data, supporting members, providers, and Managed Care Entities (MCEs) across the Next Generation Managed Care program.
 
To ensure data integrity and reduce downstream issues such as claim disruptions and inaccurate directories, providers are responsible for uploading and maintaining current, complete, and accurate information in the PNM. Providers must update changes timely and regularly review their data to keep information accurate. Details, resources, and support contacts are available in the full Provider Network Management Stakeholder memo.
 

New Owner Information Update Option in PNM

Organizations that have multiple active Medicaid IDs under the same Tax ID can now update owner information once and apply those changes to selected Medicaid IDs.  This streamlines the process and eliminates the need to re-enter the same ownership details multiple times.

Step-by-step instructions are available in the Updating or Adding Owner Information Quick Reference Guide (QRG) on the Learning tab in PNM.