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As of 10/1, the PNM becomes the front door to access all remaining MITS functionality. Prior to the Fiscal Intermediary launch on 12/1, providers will log in to PNM and if they need to access claims, eligibility, prior authorizations, or cost reports, you will click that link in PNM and be automatically redirected to MITS for those functions. 

ODM has embarked on an effort to modernize its management information systems. This modernization roadmap, developed in accordance with the Centers for Medicare and Medicaid Services (CMS) guidance, includes a transition to a modular system called the Ohio Medicaid Enterprise System (OMES) that will support us in meeting several modernization goals. As a part of this roadmap, updated and new functionality - such as Fiscal Intermediary - is built into OMES rather than MITS. Ultimately, MITS will be retired.

Providers with existing contracts with Ohio Medicaid managed care organizations (MCOs) will need to sign the updated Medicaid Addendum in order to maintain their in-network status with each MCO, unless their contract automatically amends to incorporate the current version of the Medicaid addendum. The addendum is available on the ODM webpage: https://medicaid.ohio.gov/resources-for-providers/managed-care/medicaid-addendum

To contract with any of the next generation of Ohio Medicaid Managed Care Entities (MCEs), please reach out directly to them and share your interest to enter their network contracting process. Please keep in mind that contracting is at the discretion of the Managed Care Entity. For a list of Ohio’s Next Generation Managed Care Entities and contact information please visit https://managedcare.medicaid.ohio.gov/providers.

The Next Generation mailbox remains open as a way for providers, advocates, and individuals to communicate with ODM about the current Medicaid managed care program.

When a provider completes the credentialing process, they will only have to fill out paperwork once through ODM's system. After they have received confirmation of their credentialing, the provider can begin the process of contracting with different managed care organizations. Managed care organizations cannot implement their own or a secondary credentialing process. They will, however, maintain control over their own business processes related to contracting of providers.

The Managed Care Procurement does not specifically address provider rates. However, we are working to maintain value-based purchasing arrangements or alternative payment models for as long as it benefits the providers in the system. In addition, some of the changes being made to reduce the administrative burden on providers, such as the Fiscal Intermediary and Centralized Credentialing, will benefit providers working with both our managed care and fee-for-service programs.

We are seeking to reduce the administrative burden on providers and support their ability to provide person-centered care. These will be addressed in part through new elements like the Fiscal Intermediary and Centralized Credentialing. The Fiscal Intermediary will to serve as a single point of entry for all provider claims and prior authorization requests. By bringing the credentialing process in-house, Ohio Medicaid also seeks to streamline the process for provider certification.

Feedback received from providers as well as individuals, advocacy groups and community organizations was shared with Ohio Department of Medicaid (ODM) staff for consideration as we improve our Medicaid Managed Care program.

Overarching feedback themes are being shared publicly during presentations and meetings. In addition, all the responses to Request for Information (RFI) #1, with PII removed, have been posted to the RFI #1 Responses page on medicaid.ohio.gov.

Visit the What We’ve Heard From Providers page for more information about high-level themes from the responses.

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