News Report | October 5, 2020
Ohio Medicaid Rebidding Managed Care Contracts
The Ohio Department of Medicaid (ODM) is rebidding its Medicaid managed care organization (MCO) contracts. Under the new contracts, the MCOs will be responsible for all Ohio Medicaid state plan medical benefits, including behavioral health services. However, they will no longer be responsible for pharmacy benefit manager (PBM) responsibilities or provider organization credentialing. The new MCO contracts will also include provisions to improve transparency in MCO administration and delivery of services. The MCOs will be required to coordinate with a pending prepaid inpatient health plan (PIHP) called OhioRISE (Resilience through Integrated Systems and Excellence) for youth with complex behavioral needs . . .