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February 1 Launch of Next Generation of Ohio Medicaid


The following message is from the Ohio Department of Medicaid:

Over the past year, Ohio Department of Medicaid (ODM) has prepared for and successfully launched many components of the Next Generation Ohio Medicaid program. Our implementation has consistently followed two of our key Next Generation commitments – to focus on the individual and improve the provider experience. ODM remains committed to listening to members, providers, and managed care plan partners, and we have taken a hands-on approach to resolving implementation issues that providers have experienced.  

Based on your feedback, ODM updated its launch timeline to ensure a smooth transition. So, on February 1, our seven Next Generation managed care plans will begin serving members with an increased emphasis on personalized care. At the same time, ODM's new Electronic Data Interchange (EDI) and the Fiscal Intermediary (FI) will go live. 

What can providers expect on February 1? 

Of the February 1 launch, the new EDI and FI will impact providers the most. As we phase in these new system components, some of your day-to-day processes will change while some will remain the same. Read on to understand how you will be affected. 

Claims and prior authorization (PA) submitted through trading partner 

What is not changing February 1? 

Portal submitted claims and all prior authorizations 

What are the key changes on February 1? 

What is not changing February 1

How to stay informed 

ODM will continue to use the ODM Press to provide information about the upcoming implementation for providers. In the meantime, please reach out to the Next Generation mailbox with questions. Thank you for your continued partnership and support of the Next Generation Ohio Medicaid program! 

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