The surprise bill stemmed from the hospital’s chargemaster rate, but the hospital did not provide this information to the patient before her surgery. The Colorado Supreme Court has ruled that a woman is not liable for her $229,000 surprise bill from a Centura Health hospital, as the hospital did not disclose the amount to her before the procedure. Lisa Melody French received spinal surgery at St. Anthony North Hospital in Westminster, Colorado, in 2014. The hospital initially estimated that the surgery would cost $57,601, with French responsible for paying $1,337 out-of-pocket. But the cost increased to $229,112 following the surgery. According to the court document, the new price tag reflected Centura’s full chargemaster rates for the surgery. Additionally, Centura determined that it had misread French’s insurance card and she was an out-of-network patient. French was left with the nearly $230,000 bill after her insurance paid $73,597 of the new charge, which was over $300,000. Fren

Effective August 1, 2022, ODM will not be accepting new provider enrollment applications or continue any in-progress enrollment applications through the MITS Provider Enrollment System. Details on the process for enrollment of new OhioRISE providers from August 1 to October 2022 will be communicated prior to August 1st. Effective October 1, 2022, all provider enrollment applications must be submitted using Ohio Medicaid’s new Provider Network Management (PNM) portal. After its implementation, the PNM portal will be the single point for providers to complete provider enrollment, centralized credentialing, and provider self-service. Provider Network Management Portal and Centralized Credentialing Beginning on October 1, 2022 the Provider Network Management (PNM) portal will accept Medicaid provider enrollments and carry out centralized credentialing functions. This transition will reduce administrative burden for providers and enable providers to focus on the more meaningful and importan

Learn more about the next generation of Ohio Medicaid managed care and what it means for providers IMPORTANT UPDATE: Ohio Medicaid is upgrading its provider enrollment system Effective August 1, 2022, ODM will not be accepting new provider enrollment applications or continue any in-progress enrollment applications through the MITS Provider Enrollment System. Details on the process for enrollment of new OhioRISE providers from August 1 to October 2022 will be communicated prior to August 1st. Effective October 1, 2022, all provider enrollment applications must be submitted using Ohio Medicaid’s new Provider Network Management (PNM) portal. After its implementation, the PNM portal will be the single point for providers to complete provider enrollment, centralized credentialing, and provider self-service. About Ohio Medicaid’s Next Generation Program In 2019, the Ohio Department of Medicaid (ODM) launched a series of procurements and strategic initiatives with the goal of creating a Next

As a part Ohio Medicaid’s effort to launch the next generation of Medicaid, ODM will implement OhioRISE (Resilience through Integrated Systems and Excellence), a specialized managed care program for youth with complex behavioral health and multi-system needs.

COLUMBUS, Ohio — The decision of how Ohio will spend hundreds of millions of dollars – and maybe more – in opioid settlement money will be up to a new non-profit, whose board met for the first time on Monday. The 29-member OneOhio Recovery Foundation Board consists of state representatives, local government leaders (including Cuyahoga County Executive Armond Budish), addiction treatment experts, and others from around the state. Under an agreement between state and local officials made in 2020 , the new foundation will decide how to distribute more than $440 million (or 55%) of an $808 million settlement reached last year with the nation’s three largest pharmaceutical distributors and drugmaker Johnson & Johnson. Under the agreement, another 30% of the settlement money will get distributed among more than 2,000 local governments in Ohio. The final 15% will go to the state, though Gov. Mike DeWine said OneOhio might also gain control over spending some of the state’s share. The sett

COLUMBUS, Ohio (WCMH) – May is Mental Health Awareness Month, and a central Ohio man is opening up about his struggles to shine a light on the many people who battle bipolar disorder. During his time at the Ohio State Harding Hospital for Behavioral Health, A.J. Heckman discovered healing through art in a series of drawings he’s now titled “Clarified Mania.” The National Alliance on Mental Illness estimates that 7 million people in the United States are diagnosed with bipolar disorder. Heckman said if he can help just one person who might be undiagnosed and plagued with dark, intrusive thoughts, it’s worth it to share his journey, documented through his drawings. With fortitude and newfound strength, Heckman described the dark thoughts and the mania he was feeling this past February when he took crayons to paper as part of his therapy. “And I was having thoughts of suicide,” he said. “Nothing that I dwelled on, but they were intrusive thoughts and kind of taking comfort in the idea tha

Almost 90 percent of all overdose deaths in Lucas County in 2020 were caused by the deadly drug. TOLEDO, Ohio — It might have been lost in the crisis of the COVID-19 pandemic, but it never went away. When it comes to the opioid epidemic, the synthetic opioid fentanyl is a killer that’s ruining families. “I said when are you going to hit bottom? When are you going to hit bottom?”  Peggy Montgomery was in a daily battle watching her son, Dustin Doust, battle a drug addiction. Dustin would get caught up in it, get sober again, and then fall back into dangerous habits. She had to confront him. “I finally said, you’re using. He cried and I cried and he said ‘Yeah I am.’ I said, ‘Well what are you using?’ And I never thought I would hear the word heroin. It was like somebody punched me in the heart,” Peggy said. Dustin agreed to go to rehab in Florida and Peggy thought he got better. He even moved back to Ohio. But on Jan. 26, 2018, Peggy heard her husband’s phone ringing early in the morni