The Next Generation of Ohio Medicaid program's EDI is designed to increase transparency and visibility of care services. As part of the Ohio Medicaid Enterprise System, the company Deloitte is the EDI vendor and takes responsibility for all EDI HIPAA x12 transactions.

The new PNM modular component system will replace the Medicaid Information Technology System (MITS). ODM's Next Generation PNM module is designed to deliver a streamlined process for submitting and monitoring insurance claims. The PNM module will also allow providers to submit and track prior authorizations, fee-for-service claims as well as other administrative tasks.

All managed care members will need new Next Generation ID cards. However, if a member actively made a new plan selection or was previously enrolled in Medicaid Fee-for-Service and recently enrolled in managed care. These members will continue to use their existing ID card. For members who made a new plan selection during the open enrollment period, they will receive a new Next Generation ID card. Next Generation Medicaid managed care does not apply to members enrolled in MyCare Ohio plans.

There are now a total of seven MCOs (managed care organizations) to choose from in the ODM Next Generation Medicaid system. The seven are MCOs are as follows: •AmeriHealth Caritas Ohio, Inc. •Anthem Blue Cross and Blue Shield •Buckeye Community Health Plan •CareSource Ohio, Inc. •Humana Healthy Horizons in Ohio •Molina Healthcare of Ohio, Inc. •UnitedHealthcare Community Plan of Ohio, Inc.

Ohio healthcare providers are not required to contract with all of the Next Generation managed care organizations. Healthcare providers can pick and choose which Next Generation MCO they would like to contract with for services.