Graphic of the week: Ohioans who need BH treatment report barriers with provider availability

As displayed in the figure above, a large proportion of people who were unable to access needed mental health treatment in 2025 reported that provider availability was a barrier to receiving care. This was true for all Ohio adults and children and specifically for those with Medicaid. That year, 27% of Ohio adults and 8% of Ohio children who needed mental healthcare did not receive it, according to the Ohio Medicaid Assessment Survey.

Recently, the Ohio Departments of Medicaid (ODM) and Behavioral Health (DBH) proposed several new behavioral health regulations. The proposed rules include several changes that would impact Medicaid reimbursement of intensive mental healthcare services, such as:

• Putting new requirements on the types of providers that can render these services
• Increasing the number of service time hours required for Medicaid reimbursement of certain services (e.g., from 2.5 to 3.5 hours per day) without a change in reimbursement
• Adding new requirements around provider supervision
• Changing the number of hours of services that will be covered for a patient

The rules also eliminate coverage for certain types of care (e.g., mental health day treatment) and change the definitions of several forms of treatment, limiting them to individuals with severe mental illness or severe emotional disturbances. After a public comment period, the proposed rules were filed with the State of Ohio’s Common Sense Initiative (CSI) earlier this week. CSI is accepting public comments through Oct. 12thon the ODM rules and Oct. 14th on the DBH rules. After CSI reviews proposed rules, they are filed with the Joint Committee on Agency Rule Review (JCARR) where there is another opportunity for public input.

Ohio has mental health provider shortages around the state, as shown in HPIO’s policy brief, Access to mental health care for Ohio children and youth. The Ohio Child Mental Health Project also describes challenges with low insurance reimbursement rates and administrative burdens, such as prior authorizations. These factors can contribute to practitioners deciding to no longer accept Medicaid or other forms of insurance, which hinders access to care for Ohioans with those forms of insurance.