As you may be aware, on February 21, Change Healthcare (CHC), a healthcare technology company that is part of Optum and owned by UnitedHealth Group, experienced a cyberattack that resulted in the company immediately taking their systems offline. The attack significantly impacted healthcare providers, trading partners, and Medicaid members nationwide. Upon announcement of the attack, the Ohio Department of Medicaid (ODM) disabled connections to and from CHC because of its role as an ODM trading partner and as a clearinghouse for providers and HIPAA covered entities.

ODM worked with CHC to securely re-enable the company’s Electronic Data Interchange (EDI) connectivity with the Ohio Medicaid Enterprise System (OMES). On May 6, we re-established the connection. Providers will need to reach out to CHC directly to confirm which OMES services have been re-enabled by CHC.

CHC provided the following URL where updates on re-activated payers are posted: Payer Lists | Change Healthcare.

The Ohio Department of Medicaid has begun work on the development of the Next Generation MyCare program to expand statewide and implement some of the same program requirements and benefits as the Next Generation managed care program. We aim to provide Ohioans enrolled in MyCare Ohio a better healthcare experience, improve program transparency, and decrease administrative burden for providers.

In March, the MyCare Ohio team kicked off MyCare Ohio program community input sessions to hear provider experiences navigating the current Financial Alignment Initiative demonstration, and other Fully Integrated Dual-Eligible Special Needs plan (FIDE-SNP) models. Feedback collected during the community input sessions will inform efforts to prepare you for the changes coming to the MyCare Ohio program. Learn more about the MyCare Ohio program and community input sessions by reviewing the following resources: 

• MyCare Ohio program webpage  shares information and resources about the program and the different ways members can receive services, contact information for the MyCare Ohio plans, and details about the MyCare community input sessions. 
• MyCare Ohio program community input session provider frequently asked questions shares questions and answers about the provider community input sessions.
• MyCare Ohio frequently asked questions highlights common questions about the program and options available to members.
• MyCare Ohio program one-pager provides information an individual may need to know about the program at a glance, including eligibility and where in Ohio the program is available.
• MyCare Ohio waiver one-pager provides information an individual may need to know about available waiver services at a glance.

Learn more about the MyCare Ohio program by visiting the MyCare Ohio webpage on the Ohio Medicaid website. If you have questions or feedback about the Next Generation MyCare program, please contact MyCareConversionQuestions@medicaid.ohio.gov.

The Ohio Department of Medicaid, in partnership with Maximus, the Provider Network Management (PNM) module vendor, is excited to share that we are continuing our provider awareness and training efforts around the new features implemented in the Ohio Medicaid Enterprise System. Providers will see and utilize these new features in the PNM module beginning on June 30. There is still time to register for the PNM new features training. The training schedule is available on the PNM and Centralized Credentialing page. Below you will find how to register and a list of training topics. 

Learning Management System registration  

Access the Absorb learning management system job aid and follow the steps to create your account and register for training. Absorb is where you can access virtual and self-paced training sessions. If you do not have an Absorb account, you must create one to access all training sessions, answer forms, and view a variety of PNM module resources. 

Training module topics include:  

• Fee-for-service (FFS) dental claims submission and search.
• FFS institutional claims submission and search.
• FFS professional claims submission and search.
• FFS prior authorization submission and search.
• FFS hospice member enrollment.
• Medicaid member eligibility inquiry.
• Provider financial document access (e.g., claim transaction history, 1099, remittance advice).