Ohio Medicaid’s Next Generation program launch updated to February 1

By Lisa Lawless, Communications Director, Ohio Department of Medicaid / November 17, 2022

COLUMBUS, Ohio — Ohio Department of Medicaid (ODM) Director Maureen Corcoran announced a revised schedule for the next stage of implementation of the Next Generation managed care program. On Feb. 1, ODM will launch the Next Generation managed care plans and implement the new Electronic Data Interchange (EDI). Providers and members will experience no change to how they interact with Ohio Medicaid between now and the Feb. 1 launch.

Following the February launch, the full implementation of Ohio Medicaid Enterprise System (OMES) modules will be completed, to provide streamlined processes for claims, prior authorizations, and other administrative tasks for providers.
ODM’s Next Generation implementation strategy has consistently followed two key commitments – to prioritize the needs of individual members in improving the care experience and streamlining provider administrative requirements so they can focus their time on the care of members.

“We remain committed to listening to members, providers, and managed care plan partners to thoughtfully work through these complex changes. We are taking a hands-on approach to resolving implementation issues that are being experienced by providers,” said Maureen Corcoran, director, Ohio Department of Medicaid. “The feedback from providers about the design of the new system has been very positive, but this is a work in progress, and we want to continue that momentum. As I’ve said all along, it’s more important that we get this right for members and providers than simply meeting an arbitrary deadline.”

On July 1, the agency successfully launched OhioRISE, a specialized managed care program for children with complex behavioral health needs, which today supports more than 12,000 Medicaid youth. On October 1, Medicaid’s single pharmacy benefit manager (SPBM), centralized credentialing and provider enrollment portal were introduced, bringing greater transparency and accountability to Medicaid’s $4 billion pharmacy program, and streamlining the provider credentialing process.

The complete Next Generation program has resulted from Governor DeWine’s vision for a new Medicaid program focused on the individual and consistent with his priorities for families, children, and communities.