Darlean Cummings

The committee held a meeting that included welcoming the new director, reviewing a draft letter for Director Corcoran, and receiving a presentation on conflict of interest policies and disclosure requirements. The group also discussed the timeline and implications of the One Big Beautiful Bill, including the alignment of HB 33 and HR1, member coverage goals, and challenges in identifying individuals affected by legislative changes. The committee solicited input for future discussion topics, identifying homeless veterans, preclearance rule review, and locating non-managed care providers as priorities.

The inaugural meeting of the Medicaid Advisory Committee (MAC) addressed several key organizational and procedural matters. Topics included the introduction of all MAC members, the election of Heidi Gartland as Chair and Kendra Yahns as Vice-Chair, and a review of the MAC by-laws. Discussions on the by-laws resulted in several action items, including determining the committee size should remain at 18 members, confirming minutes will be posted online, and agreeing to include a public comment period at every meeting. Future agenda topics were suggested, such as operationalizing changes from the One Big Beautiful Bill, collaboration with the Beneficiary Advisory Council, and open enrollment matters. The committee also briefly reviewed conflict of interest disclosures and received a presentation on managed care member materials, which was tabled for future discussion.

The key discussions during the meeting included a follow-up session regarding conflict of interest rules, referencing Federal Regulations that mandate disclosure time at each meeting. The committee also addressed a proposed resolution to thank the former Director Corcoran, with plans to review a draft letter at the subsequent meeting. A presentation covered Robert's Rules of Order, followed by a detailed presentation and Q&A session concerning the MyCare program, particularly regarding Buckeye's unique situation with Medicare enrollment limitations. Another agenda item focused on the Managed Care Model Material Updating and Review process, including Member Handbooks and translation services. The topic of Copays for Group VIII expansion eligibility was reviewed, covering provider discretion and MCO waiver abilities. Finally, the process by which the Ohio Department of Medicaid makes policy changes was presented.

The Ohio Medicaid Advisory Committee (MAC) will conduct a public meeting both in-person at the Ohio Department of Medicaid (ODM) offices and virtually via Zoom. The notice provides details regarding the location, time, and the online meeting link. Furthermore, it outlines procedures for requesting reasonable accommodations, interpreters, or alternative formats under the Americans with Disabilities Act (ADA) and other relevant civil rights laws, including contact information for the Civil Rights/ADA Coordinator and grievance procedures.

The meeting included roll call and conflict-of-interest statement review. Updates were provided on Health Plan Policy, noting that the Pharmacy and Therapeutics (P&T) Committee met on October 8th, decisions on the Unified Preferred Drug List will be effective January 1st, 2026, and that the semiannual OAAC survey was completed. Dispensing fee changes were announced, including the sunset of the supplemental dispensing fee and a 9.6% increase in managed care dispensing fees, accompanied by an FAQ document. Staff promotions and new hires were also announced. Key discussion topics included potential new initiatives such as HIV medication adherence, long-term benzodiazepine use, appropriate antiplatelet use, and pediatric opioid prescribing. Several re-review interventions were presented, including CKD without ACE/ARB (resulting in a 14% increase in RASI therapy claims), HFREF without Beta Blocker (resulting in a 32% increase in beta blocker therapy claims), and Stimulants and CVD (resulting in an 8% decrease in ADHD stimulant claims). Recent interventions on Benzodiazepines and High Dose-Opioids, Anticholinergic Adverse Effects, and Migraine Prophylaxis were reviewed. A new intervention proposal for Atrial Fibrillation without Anticoagulation was presented. Monthly reports on Medication-Assisted Treatment (MAT) and the Coordinated Services Program (CSP) were also presented.