The Ohio Department of Medicaid (ODM) is implementing its Next Generation MyCare program beginning on January 1, 2026. The Next Generation MyCare program has several improvements designed to better support you in serving members, such as shorter turnaround time for prior authorizations, no additional waiver prior authorization for services already in a member’s person-centered care plan (same for private duty nursing), and streamlined credentialing processes with ODM to become an Ohio Medicaid provider.
To provide services to members in the Next Generation MyCare program, you must be enrolled with ODM and contracted with the Next Generation MyCare plans by completing the following steps:
Enroll with ODM by visiting the Medicaid Provider Portal and completing the online application (credentialing, if required, will occur automatically during application processing), and;
Contract with the Next Generation MyCare plans by contacting each of the plans you wish to contract with.
Next Generation MyCare plans are not required to contract with every provider. You may still be able to set up a noncontracted reimbursement agreement (single case agreement) if you don’t have a contract.
Feel free to distribute the information contained within this update to your colleagues, organization's members, or with anyone who you think might find it useful. We want all Ohioans to know what is going on with ODM's strategic initiatives.
