Help the Ohio Department of Medicaid Spread the Word About the Next Generation MyCare Program

The Ohio Department of Medicaid (ODM) is implementing its Next Generation MyCare program starting on January 1, 2026! It will be available in the 29 counties where MyCare Ohio is available today. Later in 2026, it will be available in the rest of Ohio. In preparation for the Next Generation MyCare program, ODM requests your support to spread the word about the Next Generation MyCare program.  

As you interact with providers, help us share information about changes coming with the Next Generation MyCare program, actions required, and where to go to get help. Do this by: 

• Using the ODM-approved Next Generation MyCare provider key messages in your communications when developing and deploying communications to providers.  

• Sharing the ODM-approved email/newsletter template to raise awareness and promote the program.  

• Distributing the following resources: 

• The Next Generation MyCare Overview One-Pager helps stakeholders understand what the Next Generation MyCare program is, who it serves, and where to go for more information. 
• The Next Generation MyCare Provider Help Desk One-Pager shares contact information by topic in one place, so providers know who to contact when they have questions or need help. 
• The Next Generation MyCare Provider Frequently Asked Questions (FAQ) answers the most common questions from providers about the current and Next Generation MyCare program. 
• The Next Generation MyCare Member ID Card One-Pager provides an overview of the card template. All MyCare Ohio members will receive a new Next Generation member identification (ID) card that will be used at their appointments. 

For more information, visit the MyCare Ohio provider webpage on medicaid.ohio.gov.  

CMS Opens State Applications for $50B Rural Health Transformation Program

The Centers for Medicare & Medicaid Services (CMS) has opened up state applications for the five-year, $50 billion Rural Health Transformation Program intended to blunt, in part, upcoming cuts to hospitals’ Medicaid funding. The hotly anticipated fund was authorized by the summer’s One Big Beautiful Bill Act, allocating $10 billion each fiscal year between fiscal year 2026 and 2030. Under the statute, half of the money will be distributed equally among all approved states with the remaining half flowing at the CMS’ discretion with the broad goal of strengthening rural providers and communities. States may now access a Notice of Funding Opportunity to apply for the program before the Nov. 5 deadline, with the CMS announcing awardees by Dec. 31.Details on what must be included in the applications, how the office will be grading received applications and specific restrictions on how the funds may be used are outlined in a new FAQ (PDF) and the Notice of Funding Opportunity’s full documentation.

Ohio Fights Supreme Court Order to Pay up to $1 Billion to Nursing Homes

After a unanimous state Supreme Court decision found Ohio underpaid its best nursing homes by as much as $1 billion, the state is pushing back — asking the justices to take another look before it cuts a check.

The case centers on a dispute between nursing homes and the Department of Medicaid over how the state is supposed to calculate payments meant to reward “high-quality care. ”Nursing homes successfully argued the department got the math wrong, shortchanging them by about $527 million in the 2024–2025 budget and a similar amount in the current one. Attorneys for Ohio say the state didn’t plan to spend that kind of money. The Court still has to decide whether to reconsider its unanimous ruling. But Senate Finance Chair Cirino said lawmakers might not have to swallow the full billion-dollar bill even if it stands. He said the state could try to negotiate with nursing homes. Cirino also pointed to Ohio’s $3.8 billion rainy day fund as a possible backstop.

Government Shutdown Looms Oct. 1 as Congress Struggles with Stopgap Spending Plan

U.S. House leaders released a seven-week stopgap government funding bill Tuesday that’s intended to avoid a shutdown when the new fiscal year begins Oct. 1. 

But GOP leaders opted not to negotiate the legislation with Democrats, who may be needed to approve the bill in the House and will be required to get past the Senate’s 60-vote legislative filibuster. 

Democrats for weeks have called on Republicans to address what they view as critical health care issues, including the expiration of expanded Affordable Care Act tax credits at the end of the calendar year and the effects of the GOP’s “big, beautiful” law on Medicaid recipients.

Speaker Mike Johnson said during a press conference shortly before the bill was released that he views the ACA tax credits as “a December policy issue, not a September funding issue,” even though open enrollment begins in November. 

The tax credits are used by people who purchase their own health care coverage through the Affordable Care Act Marketplace.