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PA Lookup tool is under maintenance.
Please refer to the state specific Excel matrix while the PA Lookup Tool is disabled.
Recent Updates
Based on guidance from the Ohio Department of Medicaid (ODM) for the Next Generation Medicaid, Molina will begin denying claims submitted by non-enrolled or inactive providers on Dec. 1, 2022. Learn more here.
Credentialing Reminder: Effective Oct. 1, 2022, ODM will be the single point of contact for provider credentialing for Medicaid and MyCare Ohio via the new Provider Network Management (PNM) module. Molina will be responsible for provider recredentialing until Jan. 31, 2023. Find out more in the October 2022 Provider Bulletin, posted here.
Do You Have Your OH|ID? As of Oct. 1, 2022, all Medicaid providers need an OH|ID. Providers must obtain an OH|ID to access the PNM or Single Pharmacy Benefit Manger (SPBM) web portal and do business with Ohio Medicaid. Get your OH|ID today here.
PNM Training: Visit the ODM website to register for a self-paced training session or sign up for virtual and/or in-person learning here.
SPBM Training: Visit the Gainwell website to view Pharmacy Web Portal training or Prescriber Web Portal training. Find the Gainwell website here.
Find additional information on PNM and SPBM on the Ohio Medicaid Managed Care website here. Read the ODM 2022 Press here to stay updated on upcoming December 1 Launch Next Generation Medicaid changes. Subscribe to the ODM 2022 Press here. For questions about the Next Generation program, contact ODMNextGen@medicaid.ohio.gov.
The Combined Provider Manual became effective Oct. 1, 2022. View it here.
The current PA Code List became effective Oct. 1, 2022. View it here.
Medication Assisted Treatment
Addiction
Basics
Safety
Molina Peer Support Program
Addiction
For more information call (855) 665-4623, TTY/TDD: 711, Monday - Friday from 8:00 a.m. - 8:00 p.m. local time and ask for our Care Management department.
Medicare Compliance Program
Molina Compliance Hotline: (866) 606-3889 or Molinahealthcare.AlertLine.com
Reporting Compliance and Fraud, Waste, or Abuse
Molina Medicare Compliance Program
Code of Business Conduct and Ethics
Medicare Compliance Issues Policy
Document Retention and Destruction Policy
Medicare Fraud, Waste, and Abuse Plan
FDR Compliance Auditing Policy
Your Opinion Matters to Molina
Email us to share your comments, concerns or ideas. Your feedback is important to us. Let us know what we're doing well and what we can do to improve.
Molina Healthcare of Ohio's "It Matters to Molina" program prioritizes connecting directly with our network of over 90,000 providers and supporting their efforts to deliver high-quality and efficient health care for Molina members.
Through the “It Matters to Molina” program, we have a dedicated Provider Services Team to intake and resolve your questions or issues and solicit input and feedback from you, our network providers and administrative staff, about ways Molina can improve our technology, tools and processes to minimize administrative hurdles and better support you.