03/21/2024

ODM Begins Work on Next Generation MyCare Ohio, Kicks Off Recipient and Provider Input Sessions

The Ohio Department of Medicaid (ODM) has announced that they have begun work on the procurement of the Next Generation of MyCare Ohio. In the coming months, ODM will release a 'request for applications' for managed care plans to serve as the MyCare Ohio plans as they transition out of the Financial Alignment Initiative demonstration and move toward a Fully Integrated Dual-Eligible Special Needs Plan (FIDE SNP) model.

Plans awarded the contract will need to notify CMS of their intent to establish a FIDE SNP in Ohio by the fall of this year to be authorized to begin operations by the end of the demonstration which concludes at the end of calendar year 2025. Beginning in January of 2026, the selected FIDE SNPs will begin covering the full Medicare and Medicaid benefits for those who qualify in the current 29 demonstration counties, with statewide expansion as expeditiously as possible.

In the fall of 2022, ODM released its MyCare Conversion Charter and Principles (see here) and completed a series of meetings around the state to engage members, advocates, providers, current D-SNPs, and many others. ODM is grateful for everyone who offered feedback during this process, and they have expressed their commitment to incorporating it in developing the new MyCare program.

Opportunities to provide input

Dual-eligible recipients:

Just as ODM did prior to the launch of the Next Generation of Medicaid managed care program, ODM will host a series of in-person meetings throughout the state with dual-eligible Ohioans to gain feedback on developing the new MyCare program.  Click here for the schedule of meetings across Ohio from April through September. Sessions will be held in Jackson, Coshocton, Marietta, Mt. Gilead, Lima, Fairview Park, Englewood and Cincinnati.

Providers, associations and advocates:

ODM will also host virtual "community input sessions" with provider stakeholders and advocates over the coming months to gather input about the program:

• Kick-off session - March 26, 3-4 pm ET.  You'll learn about the current MyCare Ohio program and the approach of the program's community input sessions. Click here to register.  
• Session for waiver providers - May 22, 9-11 am ET. Click here to register.
• Session for non-institutional providers (including DMEPOS) - June 27, 3-5 pm ET. Click here to register. 
• For a full list of ODM community input sessions for all provider types, click here.

General resources:

The full ODM announcement on the future of the MyCare Ohio program. 

Learn more about the MyCare Ohio program by visiting the MyCare Ohio webpage on medicaid.ohio.gov.

If you have questions or feedback about the Next Generation of MyCare Ohio, please contact MyCareConversionQuestions@medicaid.ohio.gov.