Ohio Department of Medicaid (ODM) plans to move to a new payment system for ASCs this summer and part of that changes includes requiring prior authorization for certain procedures/reimbursements.
This is a change for ASCs, since it is not currently a part of the Medicaid ASC grouper payment methodology.
To assist OAASC members with this change, ODM will be holding a free training on prior authorization on June 14th, 2017 at 2pm.
Members can either join in person at ODM offices at 50 West Town St. in downtown Columbus or via webinar.
If attending in person - please email Randy Leffler at info@oaasc.net.
Attend via webinar - Please register at: https://attendee.gotowebinar.com/register/1849045788826992130
After registering, you will receive a confirmation email containing information about joining the webinar.
ODM will also be recording the webinar and will post it to their website (linked from the OAASC web site) for anyone who can’t make it or wants to view it again.
Please keep in mind that you can more easily get your questions answered during 6/14 2:00 presentation.
As a reminder, the new payment system moves away from the current grouper system to a new structure that seems to be more similar to current Medicare. The new Enhanced Ambulatory Patient Grouping (EAPG) system is intended to modernize payments of all outpatient services and was developed by 3M Health Services.
ODM will still be in charge of all overall payment levels (e.g., how much they pay ASC as a % of HOPDs), but the new methodology will incorporate bundling (packaging) of codes into a single payment for certain procedures. As always the devil will be in details in terms of how they set those pricing levels.
The OAASC has been working over the past year to develop more productive outcomes on Medicaid with ODMs new staff overseeing ASCs.
If you or your staff have any questions, please do not hesitate to contact the OAASC at 614-358-0177 or info@oaasc.net.