FROM THE OHIO DEPARTMENT OF MEDICAID

New Populations Moving to Managed Care

(November 22, 2016) Beginning January 2017, more Ohioans will be able to access their benefits through one of Ohio’s five statewide Managed Care Plans.

Once individuals are enrolled in a Managed Care Plan, providers should begin billing the plan and not the State. Providers who do not have contracts with Managed Care Plans may be able to provide services to current patients/clients for a “transition period.”

Managed care enrollment will be mandatory for the following population beginning January 1, 2017:

  • Medicaid eligible individuals enrolled in the Bureau of Children with Medical Handicaps (BCMH) program
  • Children in Custody (Foster Care) and Adopted Children
  • Breast & Cervical Cancer Project (BCCP) Individuals

Managed care enrollment will be voluntary for Individuals enrolled in any of the home and community based waivers administered by the Department of Development Disabilities.

The Ohio Department of Medicaid began sending informational and enrollment notices to members who are not currently enrolled with a Managed Care Plan in August 2016. If members have questions about choosing a Managed Care Plan or about enrollment options, refer them to the Ohio Medicaid Consumer Hotline at 800-324-8680.

For more information about contracting with the Managed Care Plans or how to submit claims, contact the plans’ provider services with questions:

Please note certain behavioral health services will remain billable to the Medicaid Fee-for-Service program.

For more information about managed care and the new population being enrolled please visit the Ohio Department of Medicaid’s website at http://medicaid.ohio.gov/PROVIDERS/ManagedCare.aspx


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