03/31/2022

HB 169 Provider Relief Payments announced, includes funds to nursing homes and hospices

Last week, Governor DeWine signed an executive order for the Department of Medicaid (ODM) to issue provider relief funds approved by the Ohio General Assembly in HB 169 for home health, community behavioral health, and noninstitutional durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Also authorized were payments to nursing facilities, intermediate care facilities, and hospices. Hospices, along with other Medicaid providers, will receive a calculator 10% of their Medicaid service revenue (not including room & board payments) for the period from November 1, 2020 to October 31, 2021.

Centers for Medicaid & Medicaid Services (CMS) approval has been received and the emergency rules were filed March 23. 

These provider payments were processed Thursday, March 24 through Medicaid Information Technology System (MITS). Providers will receive the EFT payments this week, with paper checks mailed afterwards. Providers will receive a separate remittance advice that includes the code “HB169COVIDPMT” to help identify the payments. As a reminder, these payments are based on fee-for-service (FFS) payments only. The calculation of these payments is equal to approximately 10% of paid claims, using claim period from July 1, 2020, through June 30, 2021, as the basis, and distributed to providers as a lump sum. 

CMS approvals that are still pending include services and equipment provided to individuals through managed care, including MyCare.   

ODM declined to share with the associations the exact amounts each provider will receive, noting that since funds were based on their Medicaid revenue, doing so would reveal confidential information. Instead, ODM has developed a tool to assist providers to know how much they are receiving and from which payor:

ODM is pleased to announce a new tool that will be available to providers beginning early next week. It is a tableau dashboard that will allow providers to enter their Medicaid billing ID and view payments that will be dispersed to them from FFS, Managed Care, and MyCare per HB 169. This includes all the categories of provider relief from HB 169, ARPA HCBS and non-ARPA/GRF funds, EXCEPT for Assisted living (RCFs) and DODD waiver providers. Providers can access this tableau through the ARPA HCBS page of our website linked here. 

Ohio Medicaid appreciates the difficulty faced by providers and the individuals each serves. We continue to work closely with CMS and impress upon them the urgency in which to move these payments as quickly and efficiently as possible. 

Community provider relief payments are contained in Ohio’s American Rescue Plan Act Home- and Community-Based Services (ARPA HCBS) plan. Additional information about the Ohio plan can be found here. 

LeadingAge Ohio encourages members to reach out to Susan Wallace with any questions related to provider relief at swallace@leadingageohio.org.