Medicaid Prescribers Need to Enroll with Ohio Department of Medicaid

The Ohio Department of Medicaid recently notified those who prescribe medications for Medicaid enrollees that on and after April 1, 2015, the department will begin to deny claims for prescriptions written by any prescriber not actively enrolled with Ohio Medicaid.

The requirement for prescribers to enroll is a provision of the Patient Protection and Affordable Care Act of 2010. All prescribers serving Medicaid patients MUST enroll, and their name AND National Provider Identifier (NPI) must be recorded on claims for prescription medications submitted to the department on and after April 1.

Providers may enroll as a billing provider or an “Ordering, Referring or Prescribing (ORP) provider.” ORP-only provider is a category for prescribers who write orders, refer, or prescribe medications but do not actually submit claims to Medicaid for their services. These providers may not bill the department for services. They are also not listed in the Ohio Medicaid provider directory.

If you’re already enrolled in MITS, log on to the Ohio Department of Medicaid website to enroll as a billing provider or an ORP-only provider. The application can be found here. To learn more about the ORP enrollment, click here.

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