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Children’s Health Care and the Medicaid Managed Care Program

Information for July 1, 2013 Implementation

The following memo was released 1/28/12 by the Ohio Office of Medical Assistance (Ohio Medicaid) regarding the expansion of Medicaid Managed Care Program effective July 1, 2013:


To:       Medicaid Providers, Interested Stakeholders

From:   John McCarthy, State Medicaid Director, Ohio Office of Medical Assistance

Date:   January 28, 2013

Who Will This Affect?

Approximately 37,000 Ohio children who are currently eligible for Medicaid in Ohio due to a disability will be enrolled into managed care. (This will not affect children who are enrolled on a Medicaid waiver; or children who reside in institutional settings; or children who receive both Medicare and Medicaid benefits; or those eligible for Medicaid by spending down their income or resources.)

What Will Happen?

Each eligible child will be enrolled in a Medicaid managed care plan of his/her choice. Families will be able to choose from five managed care plans to determine which one is right for their child. Click here for a link to the regional map with plans effective 7/01/2013:


July 1, 2013


This population of Medicaid‐eligible children is currently served through Ohio’s fee‐for‐service program but receive little assistance in accessing and coordinating care. Without some form of care coordination, these children will continue to experience difficulties in managing complex conditions and may have less desirable health outcomes at a significant cost to the Medicaid program. The Medicaid Managed Care Plans will assist children and families in getting the services they need.

Need more information?

Over the coming weeks and months, the Office of Medical Assistance (OMA) will provide updates regarding the enrollment and transition of these children. OMA is working with families, advocates, managed care plans, providers and other stakeholders to ensure a smooth implementation process. If you have any questions, please contact OMA’s Bureau of Managed Care at

For more information about Ohio Medicaid and the latest health care initiatives underway in Ohio, please visit Office of Health Transformation’s website at

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