OhioRISE enrollment to begin first day of eligibility month

Starting July 1, 2026, enrollment in OhioRISE is effective on the first day of the calendar month of eligibility.

This change is due to an amendment by the Ohio Department of Medicaid (ODM) to OhioRISE eligibility and enrollment rule 5160-59-02 to align with managed care program enrollment and help reduce manual retro-enrollments due to inpatient behavioral health admissions.

What you need to know

• Review workflows for services that may span pre‑ and post‑enrollment dates
• Submit claims in alignment with updated OhioRISE enrollment timelines
• Coordinate with managed care plans, which remain responsible for CANS assessments completed prior to OhioRISE enrollment
• Watch for updates to the OhioRISE Mixed Services Protocol reflecting this rule change
• Visit the UnitedHealthcare Community Plan website for additional information and resources