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

Invisible Algorithms: The Hidden Role of Artificial Intelligence in USCIS Immigration Processing

February 10, 2026The Department of Homeland Security has confirmed that artificial intelligence and machine learning tools are now integrated into numerous operational functions within U.S. Citizenship and Immigration Services (USCIS). These tools are described as mechanisms to improve efficiency, reduce backlogs, and assist officers in managing an unprecedented volume of applications. DHS emphasizes that human adjudicators retain decision-making authority and that AI systems do not independently grant or deny immigration benefits. Find out how AI affects the U.S. immigration process.Client Alert

OAAPN | Year In Review: 2026 Ohio Board of Nursing and Ohio Law Rules

February 9, 2026Find out key changes to Ohio law and the Ohio Board of Nursing rules that have directly impacted APRN practice over the past year, including Psychiatric Inpatient Documents, Intimate Examinations, Signature Authority, Duties Related to Fetal Death, Retail IV Therapy Clinics, Release from Permanent Restrictions, Disciplinary Action, Course on Drugs and Prescriptive Authority, Overdose Reversal Drugs, Office Based Opioid Treatment, Withdrawal Management for Substance Use Disorder, Safe Haven Program, and more.Client Alert

Ohio House Bill 537: Proposed Regulations for Midwives and Birthing Centers

January 28, 2026House Bill 537, introduced in the Ohio House of Representatives, proposes a comprehensive regulatory framework for certified nurse-midwives, certified midwives, licensed midwives, and traditional midwives. The legislation would clarify scope of practice, establish licensure standards, and impose new requirements for freestanding birthing centers and home births. Healthcare providers and facilities should be aware of the proposed changes and their potential operational impact.Client Alert

Proposed Health Information Privacy Reform Act Expands Protections Beyond HIPAA

January 26, 2026The Health Information Privacy Reform Act (HIPRA) seeks to extend privacy protections to health data not covered under HIPAA, including data collected by apps and wearables. HIPRA introduces broader definitions of protected health information, strengthens privacy and security requirements, establishes patient notification rights, and sets national de-identification standards. Companies processing health data should monitor developments to ensure compliance.Client Alert

Medicare Updates on Skin Substitutes: LCDs Withdrawn, Payment Changes Take Effect

January 23, 2026Medicare’s planned Final Local Coverage Determinations (LCDs) for skin substitutes were withdrawn in late December 2025, meaning previous coverage rules remain in effect. The 2026 Medicare Physician Fee Schedule introduces a single payment rate of approximately $127.14 for these products. Providers should review implications for diabetic foot and venous leg ulcer treatments.
Older posts