On and after April 1, the Ohio Department of Medicaid will begin to deny claims for prescriptions written by any prescriber not actively enrolled with Ohio Medicaid. Failing to enroll with Ohio Medicaid as a prescribing provider could cause serious consequences for your patients.
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, and 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. “ORP?only providers” may not bill the department for services. Also, please note that “ORP?only providers” are not listed in the Ohio Medicaid provider directory.
If you are not already enrolled in MITS, you may go to the Ohio Department of Medicaid website and enroll as a billing provider or as an “ORP?only provider.” The quickest enrollment option is the OPR?only application process. Enrollment as an ORP?only can be processed by the Ohio Department of Medicaid’s provider enrollment center within a few days. You may access the ORP?only application process on the Ohio Department of Medicaid website.
To prevent interruptions in Medicaid client access to needed prescription medications physician prescribers must make sure they are enrolled with Ohio Medicaid.
Questions can be directed to the Ohio Medicaid Provider Call Center by calling 800.686.1516.