THE OHIO DEPARTMENT OF MEDICAID MYCARE OHIO PROVIDER AGREEMENT FOR MYCARE OHIO PLANThe Ohio Department • June 17th, 2015 • Ohio
Contract Type FiledJune 17th, 2015 JurisdictionThis Provider Agreement (herein Provider Agreement or Agreement) is entered into between the State of Ohio, The Ohio Department of Medicaid, (hereinafter referred to as ODM) whose principal offices are located in the City of Columbus, County of Franklin, State of Ohio, and INSERT CORPORATE NAME, MyCare Ohio Plan (hereinafter referred to as MCOP), an Ohio corporation, whose principal office is located in the city of INSERT CITY, County of INSERT COUNTY, State of Ohio.