02/24/2022

Cutting Through the Confusion About HB169 Relief Funds: Tomorrow at 11:30AM

Last week, the Ohio Department of Medicaid (ODM) was forced to change its approach to disbursing relief funds appropriated via HB169, after the Centers for Medicare & Medicaid Services (CMS) required that payments based on claims and utilization data – the method in which ODM had planned to distribute – would need to be disbursed via both MITS and managed care plans. This change to distribute through the managed care plans would lengthen the timeframe for disbursement significantly. To minimize the amount that is delayed, ODM has changed its approach based on provider type.

Nursing homes and assisted living will receive payments calculated by number of beds (vs. claims and utilization data), effectively circumventing the CMS requirement to distribute through the managed care plans. Unfortunately, since a similar workaround isn’t possible for hospice and home- and community-based providers, these providers will experience delays in payments, as portions of payments will be first disbursed to managed care plans who will then pay providers. Furthermore, hospices will see the total amount of relief reduced from $23 million to $3.7 million, as room and board payments will not be part of the calculation.

This pivot has caused significant confusion among providers and may cause significant delays in payments made to home- and community-based providers and hospices in particular. This Friday at 11:30AM LeadingAge Ohio will host a webinar to cut through the confusion so that each of the provider types receiving relief funds—nursing homes, assisted living, hospices and home- and community-based services—will know what to expect in the coming weeks.

To register, click here. To pose questions ahead of the webinar, email Susan Wallace, Chief Policy Officer at swallace@leadingageohio.org.