In a shocking move, mental health practices across the Miami Valley are grappling with massive Medicaid recouping claims from CareSource.
These claims are said to work retroactively back to 2024 and could cost practices tens of thousands of dollars. For all but larger practices, these claims will be devastating. Many local practices say that it could close their doors for good.
Behavioral health providers said CareSource sent out claims to them with no official notice, claiming a Medicaid billing error and that practices would have their compensation slashed and they’d have to pay CareSource back retroactively for the missed compensation starting from early 2024.
“Nobody had any time to prepare for this,” said Carla Urbanas, owner of Professional Counseling Services of Ohio. “They’re saying that they are going to cut the rates by 15% and that they’re going to go retroactive on that. So, we’re not really sure how they can do that.”
Carla is among many who are grasping for answers. She said there’s been no response to her attempts to reach out.
CareSource has claimed the error should be rectified by their clients’ compensation being reduced despite contracts providers say are still valid.
“It’s been pretty detrimental,” said Kari Root, a patient at a local practice. “We don’t have the full scope of really what’s going on, but what has been put out there to the public is deeply concerning.”
Kari said behavioral health has had a special place in her life for not only her but her friends and family, and is concerned about the ripple effects that could be felt statewide.
“It hits me personally as a patient, but it really should concern every Ohioan,” she says.
Renee Pinkelman, who owns a practice in Greene County, says her staff has done the math, and her practice could owe close to $200,000.
“When you multiply this impact statewide, we’re going to have a real unemployment crisis and a mental health crisis,” she says.
She and others reiterated that this move is unprecedented and completely out of the blue.
“I’m really curious to hear what would make him want to jeopardize the respect that CareSource has always had,” she says.
There are some class-action suits in motion already.
CareSource has not issued a statement, and the Ohio Department of Medicaid has not responded to messages from 2 NEWS.
Copyright 2026 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
For the latest news, weather, sports, and streaming video, head to WDTN.com.