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ODM Press
August 8, 2025
The ODM Press is a periodic email update on the progress of the ODM strategic initiatives for providers, associations, and advocacy organizations.
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The Ohio Department of Medicaid (ODM) is implementing its Next Generation MyCare program beginning on January 1, 2026. The Next Generation MyCare program is designed to better support you in serving members. Improvements include 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:
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Enroll with ODM by visiting the Medicaid Provider Portal and completing the online application (credentialing, if required, will occur automatically during application processing).
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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.
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On behalf of the Ohio Department of Medicaid (ODM), the Ohio Colleges of Medicine Government Resource Center (GRC) at The Ohio State University is conducting an evaluation to understand the effects of the SUD 1115 Medicaid Waiver. The GRC is hoping to speak to individual providers employed by Ohio Department of Mental Health & Addiction Services-certified Community Substance Use Disorder Treatment organizations (entities enrolled in Ohio Medicaid as Provider Type 95). They would like to speak with providers in southeast, central, and northeast Ohio who work directly with patients with substance use disorder. You may qualify to participate if you serve in any of the following roles:
- Doctor (MD, DO) or nurse (APRN, CNP, CNS, CRNA, CNM) who can prescribe medication for substance use disorder,
- Nurse who works with patients with substance use disorder but can’t prescribe medication for substance use disorder (CNA, STNA, LPN, RN), or
- Peer recovery supporter, clinical social worker, or chemical dependency counselor who works with patients with substance use disorder
If you qualify and are available for a 30-minute conversation in July or August 2025, please send an email to Zach Weisbrodt on the research team (grchealthstudy@osumc.edu) to coordinate a time to connect.
Thank you for your consideration. Your feedback would greatly support ODM’s efforts to advance treatment options and accessibility for Ohioans with substance use disorder. We look forward to hearing from you!
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The Ohio Department of Medicaid (ODM), 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. Training is scheduled for August 19 - 28. The training schedule is available on the PNM and Centralized Credentialing page.
Registration steps for enrolling through the learning management system
Access the Absorb learning management system to register for the training. If you do not have an Absorb account, you must create one to access all training sessions, answer forms, and view various PNM module resources. For help, please see our job aid and follow the steps to create your account and/or register for training.
Training topics
- Provider Administrator Role (including change of provider administrator process)
- Provider Agent Role
- New Medicaid Enrollments (first-time applications entered by the provider administrator)
- Updating/Changing to Medicaid Enrollment Information
- Medicaid Enrollment Revalidations
- Entering and Searching for Professional Claims
Note: Additional session details are available within the Absorb course listing.
For more information
To learn more about the PNM module and Centralized Credentialing, visit the PNM and Centralized Credentialing page on the ODM Next Generation website. If you are experiencing technical issues accessing the PNM module or have specific questions, please contact the ODM Integrated Helpdesk at 800-686-1516 from 8 a.m.-4:30 p.m. Monday-Friday, Eastern time. You can also email your questions to IHD@medicaid.ohio.gov.
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ODM is revamping the ways we connect with providers and all our members. Follow us for updates on healthcare coverage, wellness tips, and important information for Ohioans. Stay connected and informed about the latest initiatives and resources available.
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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.
Please also encourage anyone who you think might be interested in receiving similar updates to subscribe to the ODM Press. To view our past newsletters, please visit our website here.
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