Medicare AdvantageAdministrativeMedium impact
5160-58-05 - MyCare Ohio: care coordination. (New/Final File)
Ohio Medicaid·OH·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Ohio has established a new rule for MyCare Ohio care coordination effective January 1, 2026. This rule governs care coordination requirements for Ohio's dual eligible special needs plan (D-SNP) that serves Medicare-Medicaid beneficiaries.
Action Required
Before January 1, 2026: Billing team should review MyCare Ohio care coordination requirements if serving dual-eligible Medicare-Medicaid patients in Ohio. Contact Ohio Department of Medicaid at 614-752-3877 for specific billing and documentation requirements. Update patient eligibility verification processes to identify MyCare Ohio members.