Jessica Roe, Credentialing Manager Mar 8, 2023 12:41:41 PM 4 min read

2023 Ohio Medicaid Updates For All Providers, Groups, and Organizations

As of February 1, 2023, Ohio Medicaid’s new initiatives have launched. This includes launching the new Next Generation Medicaid MCO plans: Anthem Medicaid, Humana Medicaid and AmeriHealth Caritas Medicaid. So what does this mean for providers? Not surprisingly, it means that practices can expect to see patients with these plans as of February 2023. Additionally, it means that any new provider enrollment or updates for the Medicaid MCO plans (both the previously mentioned new plans and the existing plans) must now be made in Medicaid’s PNM system.

The Ohio Department of Medicaid (ODM) has made several changes during the past year, and this trend will continue in 2023. ODM announced on January 31, 2023, for example, that there is a pause on all provider, group and organization agreement revalidation/recredentialing due dates. Previously, Medicaid had stated that they would change the Medicaid revalidation dates for enrollment types that were due during the COVID-19 Public Health Emergency. This appears to have been done for some providers when Medicaid launched their PNM system and reinstated revalidations on October 1, 2022.

The information released at the end of January confirmed that Medicaid would again be pausing the revalidation/recredentialing process; however, this time it would only be for 180 days. Important to note, this will only apply to providers, group and organizations who have not already started the revalidation process. If an enrollment’s due date has already passed or has a future date, that due date will be delayed 180 days. Additionally, this change will only apply to revalidation applications that have not already been started or submitted. So, if you started a revalidation application, but have not yet submitted it, you will need to make sure to complete it, as the delay will not apply.

Medicaid seems to still be working out the issues in the PNM system, while trying to keep things moving as smoothly as possible. For help getting access or if you experience any issues, you can call Medicaid at 800-686-1516 or email them at

The COVID-19 Public Health Emergency will be ending on May 11, 2023, which could mean that more changes are on the way for Medicaid. We will work to share updates as they are available. In the meantime, you can find more information on PNM and Medicaid’s Next Generation plans on the Ohio Medicaid Managed Care website.