Getting QIP Payments Right:

Recalculating Rates and Back Payments

In September 2025, the Supreme Court affirmed that the Ohio Department of Medicaid did not correctly calculate the quality incentive payments (QIP) in accordance with Ohio law. The Court ordered the agency to recalculate the rates to align with statutory language first passed in HB33, the SFY 2024-2025 biennial budget bill.  

 

Background

The Supreme Court's ruling affirmed the plaintiffs' (LeadingAge Ohio, Ohio Healthcare Association, and The Academy for Senior Health Sciences) interpretation of the statute, but did not provide a guidance on the estimated $572 million in back payments owed to nursing home operators. 

The Ohio Department of Medicaid communicated in late January 2026 its intent to recalculate rates and address back payments once legislators make appropriations.

LeadingAge Ohio is hopeful that the Department of Medicaid and the Ohio General Assembly will work together to ensure that Ohio nursing homes are paid funds owed from July 2023 until present day.

 

What's Next

Legislative Advocacy

LeadingAge Ohio is actively educating lawmakers on the need for accurate and timely appropriations. We also urge members to connect with their lawmakers about the ongoing delays with appropriate reimbursement and the effects on their organization.  In the member toolkit, members can find talking points and a fact sheet leave behind for legislators. There is also a sample letter to legislators that includes space to demonstrate the financial impact on your organization. To request a Provider Impact Snapshot, email Susan Wallace at swallace@leadingageohio.org.

Legal Action

While the Supreme Court’s ruling on the mandamus action affirmed the rate interpretation and recalculation, it was silent on the disbursement of retroactive payments. If the Department of Medicaid and the General Assembly fail to act timely to address this, individual providers may need to take up the issue in lower courts.

LeadingAge Ohio is preparing education on legal remedies available to providers should back payments continue to be delayed. 

  

Resources

Special Advocacy in Action Grassroots Training: February 16, 2026

Member Toolkit

Find Your Legislator

Legal Remedy Education

  • TBD

Member Communication

Media

Ohio Medicaid underpaid nursing homes by $572M: What's happening now with underpayments?

 

 

 

Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.