The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.
Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.
| The Academy Weekly Headlines from 2 Weeks Ago|
Ohio House to tackle aging, dementia issues
The Ohio House of Representatives has made aging issues a priority by creating a separate committee dedicated to aging: Aging and Long-Term Care Committee. Further emphasizing the new focus on dementia care, the Speaker has also created a special task force on Alzheimer's and Dementia. This follows recently passed legislation (HB470) that directs ODH and AGE to develop recommendations on standards and quality measures for memory care units. And new federal regulations require all nursing home staff to undergo some form of dementia training. If you have a background in dementia care and are interested in becoming involved at the policy level, please contact The Academy.
MyCare Ohio: Molina 2017 updates
Molina has provided several updates that take effect in 2017:
- Effective January 1, all members must call 2 business days in advance to schedule transportation; 48-hour notice will no longer be accepted. Secure Transportation will transport ambulatory members to
and from nursing facilities. Molina Healthcare is developing a comprehensive list of all contracted transportation providers. The list will be available on their website in January and will include:
- Type of services offered
- Counties served
- Hours of operation
- Effective January 31, the following medications will require prior authorization (PA). Fax PA requests to (800) 961-5160.
- Lidocaine 5% ointment
- Alora patches
- Trazodone 300mg
- Effective January 1, several changes have been implemented to the dental benefits and the provider manual:
Select codes will now require PA. For adult Medicaid members, cleanings will increase to two per year. The complete list will be updated in the Dental Provider Manual benefits grid and posted to the website.
Some of these changes include, but are not limited to:
- D0120 - increased to one per six months per patient for all ages
- D1110 - increased to one per six months per patient for all ages
- D4341 & D4342 - decreased to one per 24 months per quadrant per patient all ages
- D0350, D0470, D7260, D7280, D8210, D8670 and D8680 will require PA
- D9610 will no longer require PA
Three new codes have been added:
- D1575 - Distal shoe space maintainer
- D7283 - Placement of device to facilitate eruption of an impacted tooth
- D7210 - Surgical extraction
- Effective February 1, Molina Healthcare will remove several PA requirements. The current PA Code List and the updated PA Code List reflecting these changes are both posted to their website.
MyCare Ohio: CareSource therapy prior auth clarification
As noted in the last Weekly, CareSource will be requiring prior authorization for Part B therapy services beyond 30 visits beginning January 15. CareSource has clarified that it is a 30 visit maximum for each type of therapy, not combined. Providers can request prior authorization via the CareSource provider portal. Providers can register for the portal here: https://www.caresource.com/providers/ohio/caresource-mycare-ohio/plan-resources/provider-portal/.
The provider letter explaining the change and the billing codes impacted can be viewed by clicking here.
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