Ohio Medicaid Managed Care

Ohio Medicaid Managed Care Annual Open Enrollment is Here

We know that members’ needs are ever changing. That’s why we encourage you to review and select a managed care plan that best fits your healthcare needs during annual open enrollment running now through November 30.

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Providers

Learn more about the Next Generation of the Ohio Medicaid program and what it means for providers.

OhioRISE

Learn more about OhioRISE (Resilience through Integrated Systems and Excellence), a specialized managed care program for youth with complex behavioral health and multisystem needs.

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Attention

Effective January 1, 2026, the Centers for Medicare & Medicaid (CMS) Interoperability and Prior Authorization final rule (CMS – 0057-F) will go live!

Learn more here

Update Contact Information

Important changes are coming to Ohio Medicaid. Update your contact information to stay informed about your Medicaid plan and coverage.

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Highlights

Get more information about the Ohio Medicaid Managed Care program and the Managed Care Procurement.

Fiscal Intermediary

Learn more about the Ohio Medicaid Fiscal Intermediary.

Fiscal Intermediary

Managed Care Procurement

Learn about the Ohio Medicaid Managed Care Procurement.

Managed Care Procurement

Next Generation of Ohio Medicaid Managed Care

Learn about the future Ohio Medicaid Managed Care program.

Next Generation of Ohio Medicaid Managed Care

PNM & Centralized Credentialing

Attention: Effective January 1, 2026, the Centers for Medicare & Medicaid (CMS) Interoperability and Prior Authorization final rule (CMS – 0057-F) will go live! Learn more about what it means for patients, payers and providers at Fact Sheet.

PNM & Centralized Credentialing

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Ohio Medicaid’s Next Generation program launch updated to February 1

Ohio Department of Medicaid (ODM) Director Maureen Corcoran announced a revised schedule for the next stage of implementation of the Next Generation managed care program.

Ohio Medicaid launches innovative pharmacy benefit and simplified provider credentialing in its phased Next Generation managed care implementation

Rollout introduces a new era of pharmacy transparency with the single PBM, and eases provider administration to better serve members

Governor DeWine Announces Launch of OhioRISE, First-Ever Highly Specialized Behavioral Health Program for Kids with Most Complex Needs

Ohio Governor Mike DeWine today announced the official launch of Ohio Resilience through Integrated Systems and Excellence (OhioRISE), a new Ohio Medicaid specialized managed care behavioral health program for young people with the most complex needs. Nearly 5,500 children and youth can access services immediately.

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Ohio Medicaid Managed Care