MedicaidPrior AuthHigh impact
[Ohio] Level of Care and Prior Authorization Requirements for Medicaid Covered Nursing Facility (NF) Stays
CareSource·OH·Provider Bulletin
We identified it
Jun 13, 2026
Summary
CareSource is reminding Ohio providers that nursing facility (NF) claims require valid Level of Care (LOC) determinations and prior authorization before admission. Claims will be denied without current prior authorization or LOC documentation.
Action Required
Immediately: For all nursing facility admissions, billing team must verify current prior authorization and Level of Care (LOC) determination from CareSource before submitting claims. Use provider portal, fax 1-888-752-0012, or call 1-800-488-0134 for Medicaid SNF/NF requests. For MyCare requests, email MyCareLTCAuthorizations@CareSource.com or fax 1-844-417-6157. Claims will be denied without current authorization.