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

Enhancing Privacy Protections for Substance Use Disorder Patient Records

February 16, 2024On February 8, 2024, the U.S. Department of Health and Human Services (“HHS”) finalized updated rules to 42 CFR Part 2 (“Part 2”) for the protection of Substance Use Disorder (“SUD”) patient records. The updated rules reflect the requirement that the Part 2 rules be more closely aligned with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) privacy, breach notification, and enforcement rules as mandated by the Coronavirus Aid, Relief, and Economic Security Act of 2020.Client Alert

Columbus, Ohio Ordinance Prohibits Employers from Inquiries into an Applicant’s Salary History

January 30, 2024Effective March 1, 2024, Columbus employers are prohibited from inquiring into an applicant’s salary history. Specifically, the ordinance provides that it is an unlawful discriminatory practice to:Client Alert

The Ohio Chemical Dependency Professionals Board’s Latest Batch of Rules: What Providers Should Know

January 26, 2024The Ohio Chemical Dependency Professionals Board has introduced new rules and amendments, covering various aspects such as CDCA certificate requirements, expanded services for LCDCs and CDCAs, remote supervision, and reciprocity application requirements. Notable changes include revised criteria for obtaining a CDCA certification, expanded services for LCDCs and CDCAs, and updated ethical obligations for licensees and certificate holders, including non-discrimination, confidentiality, and anti-sexual harassment measures.Client Alert

Governor Mike DeWine and The Ohio State University Introduce the SOAR Study on Ohio Mental Illness

January 22, 2024On January 19, Ohio Gov. Mike DeWine and The Ohio State University announced a new research initiative, the State of Ohio Adversity and Resilience (“SOAR”) study, which will investigate all factors influencing Ohio’s mental illness and addiction epidemic.Client Alert

CHANGING TIDES: Summary and Effects of Burnett et. al. v. National Ass’n of Realtors, et. al.

January 17, 2024In April 2019, a class-action Complaint was filed in federal court for the Western District Court for Missouri arguing that the traditional payment agreements employed by many across the United States amounted to conspiracy resulting in the artificial increase in brokerage commissions. Plaintiffs, a class-action group comprised of sellers, argued that they paid excessive brokerage commissions upon the sale of their home as a result of the customary payment structure where Sellers agree to pay the full commission on the sale of their property, with Seller’s agent notating the portion of commission they are willing to pay to a Buyer’s agent at closing on the MLS or other similar system.
Older posts
Newer posts