Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

The Ohio Department of Medicaid Announces Four Next Generation MyCare Plans

Client Alert
November 11, 2024

On November 1, 2024, the Ohio Department of Medicaid (ODM) announced four managed care organizations that will become ODM’s Next Generation MyCare plans starting January 2026. MyCare Ohio is a managed care program that supports Ohioans across 29 counties enrolled in both Medicare and Medicaid.

Currently, Buckeye Health Plan, CareSource, Molina HealthCare of Ohio, Aetna Better Health of Ohio, and United Healthcare Community Plan make up the MyCare plans available to plan participants. Ohioans will continue to receive coverage under the existing MyCare plans until the Next Generation MyCare plans take effect in 2026.  

ODM’s Next Generation MyCare program strives to enhance both the MyCare member and provider experience. ODM Director Maureen Corcoran shared that the Next Generation plans were selected “after more than a year of stakeholder engagement efforts that gathered patient feedback from members, family caregivers and other stakeholders across the state.”[1] She explained that these efforts helped ODM to “understand their experiences with healthcare and the associated life choices, with a focus on how to improve individual health outcomes and population wellness.”[2] As a result, ODM awarded the following plans to serve MyCare members starting in 2026:

  • Anthem Blue Cross and Blue Shield
  • Buckeye Health Plan
  • CareSource
  • Molina HealthCare of Ohio

Members currently enrolled in Aetna Better Health of Ohio or United Healthcare Community Plan will be required to select a new plan from the list of Next Generation MyCare plans. ODM will provide these members with enrollment information before their coverage lapses in January 2026.

For MyCare members currently enrolled in Buckeye Health Plan, CareSource, or Molina Healthcare of Ohio, no action is required for those who would like to continue with their existing plan. However, they may elect to change their coverage to a different Next Generation plan.

The newly selected plans promote the program’s goals of:

  • Focusing on the individual
  • Improving individual and population wellness and health outcomes
  • Creating a personalized care experience
  • Supporting providers in continuously improving car
  • Improving care for individuals with complex needs to promote independence in the community
  • Increasing program transparency and accountability

ODM stated that statewide expansion of the program is expected to follow the transition to the Next Generation MyCare plans.

If you have questions about the Next Generation MyCare program, please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Kate Crawford at khcrawford@bmdllc.com.

[1] Ohio Medicaid Announces MyCare Ohio Plans Chosen to Serve Ohioans in Next Generation Program, Ohio Dept. of Medicaid (Nov. 1, 2024), https://medicaid.ohio.gov/news/press-release/odm-nextgen-mycare-ohio-plans.

[2] Id.

Ohio Department of MedicaidMyCareMedicareMedicaid
Client Alert

HOA Construction Project Do’s and Don’ts

January 20, 2025Local regulators can approve new construction, but if a resident contacts their homeowners association there may be trouble. Fences, yard alterations, and backyard decks do not have to be such a hassle and a point of conflict. Find out general Do’s and Don’ts to help HOA residents avoid issues in this article by BMD Partner Scott Heasley.Client Alert

New Ohio Recovery Housing Rules Take Effect January 1, 2025

January 2, 2025Ohio’s new recovery housing rules, effective January 1, 2025, require certified community behavioral health providers to refer clients only to accredited recovery housing residences listed on the statewide registry.Client Alert

SCOTUS to Weigh In on Medicaid Beneficiaries’ Right to Choose their Provider

January 2, 2025The U.S. Supreme Court will hear arguments this spring on whether Medicaid beneficiaries have an enforceable right to choose their healthcare providers without state interference, as outlined in Section 1902(a)(23) of the Social Security Act. This case stems from a South Carolina petition challenging a Fourth Circuit ruling that blocked the state from terminating Planned Parenthood’s Medicaid provider agreement.Client Alert

I Went to Bed and the Rules Changed: the Corporate Transparency Act is Back on Hold

December 27, 2024The United States Court of Appeals for the Fifth Circuit ordered on December 26, 2024 that in an effort to “preserve the constitutional status quo” while it considered the Federal Government’s appeal, it vacated the prior order for a stay of the nationwide injunction pending appeal entered on December 23, 2024, and reinstated the preliminary injunction enjoining enforcement of the CTA and its corresponding Reporting Rule.Client Alert

Telemedicine Flexibilities Extended to March 31, 2025

December 26, 2024The American Relief Act of 2025 extends key telehealth flexibilities through March 31, 2025, originally enacted during the COVID-19 Public Health Emergency (PHE). These flexibilities remove geographic and originating site restrictions for Medicare patients, expand the list of qualified practitioners, and allow for audio-only services and telehealth mental health care without in-person requirements. Although this extension is temporary, it provides continued access to essential healthcare services. Congress will need to pass permanent legislation to solidify these changes beyond March 2025.
Older posts
Newer posts