Aging Services Institute<\/a>. \u201cIt did not suggest a path forward. It ordered one.\u201d<\/p>\nBut as January draws to a close, those payments have not been made.<\/p>\n
Nursing homes say the delay has created tax consequences tied to money they haven\u2019t received.<\/p>\n
\u201cMany providers operating on an accrual tax basis are being advised by their accountants that they may have to recognize these unpaid funds as income,\u201d Ohio Health Care Association CEO Scott Wiley said. <\/p>\n
The Ohio Department of Medicaid and the chairs of the House and Senate finance committees did not respond to requests for comment about when the payments will be made.<\/p>\n
The dispute, explained<\/p>\n
Thousands of Ohioans rely on Medicaid to help pay for nursing home care. And for many nursing homes, the state is their biggest customer.<\/p>\n
Ohio pays nursing homes a daily rate for each Medicaid resident, which is calculated in two parts. One covers the basic cost of care. The other is a quality incentive, which rewards facilities that meet higher performance standards.<\/p>\n
Every few years, the state recalculates those rates to reflect rising costs. That process is known as rebasing, and it\u2019s where the lawsuit began.<\/p>\n
Under the state\u2019s approach, imagine the base cost of care rose from $150 to $200. That\u2019s a $50 increase. Ohio then applied a 60% quality incentive to that increase, meaning high-performing nursing homes received an extra $30 per patient.<\/p>\n
Nursing homes said that calculation left out an important factor: patient complexity.<\/p>\n
Facilities that care for sicker, more medically complex patients are paid more per day. For example, a nursing home might have been paid $300 per day under the old rates and $400 per day after rebasing.<\/p>\n
Under that scenario, the increase was $100. And 60% of that would be $60, not $30.<\/p>\n
By using the lower number, nursing homes argued, Ohio shortchanged facilities that care for the most medically complex residents. The Supreme Court agreed.<\/p>\n
How much will Ohio owe? <\/p>\n
In court filings, Ohio Medicaid said that the nursing homes\u2019 interpretation would cost about $285.6 million more per year than lawmakers intended.<\/p>\n
That\u2019s where the roughly $1 billion figure comes from\u2014it reflects underpayments across two budget periods.<\/p>\n
But lawmakers changed the formula in November.<\/p>\n
\u201cThe nursing homes are going to get what the court said they get,\u201d Republican Rep. Brian Stewart, of Circleville, said at the time. \u201cBut that\u2019s looking backward.\u201d<\/p>\n
Going forward, Ohio would use the method Medicaid argued for.<\/p>\n
Ohio\u2019s Department of Medicaid did not respond to a request for comment. But the legislative change could mean Ohio owes around $762 million, rather than $1 billion.<\/p>\n
When will Ohio pay?<\/p>\n
How much the state ultimately owes\u2014and when nursing homes will see the money\u2014depends on the Ohio Department of Medicaid, providers say.<\/p>\n
Wiley said his group has repeatedly reached out to the department since the court\u2019s ruling, offering to work with state officials on a plan to recalculate the rates and issue payments.<\/p>\n
\u201cTo date, they have not provided any indication of when\u2014or if\u2014they intend to comply,\u201d Wiley said.<\/p>\n
He also said nursing homes should not be penalized for delays \u201cthat are fully within the state\u2019s control.\u201d<\/p>\n
\u201cWe also sincerely hope state officials will not put themselves in a position of risking contempt by failing to comply,\u201d Wiley said.<\/p>\n
Gov. Mike DeWine, when asked about the situation, said he would take the tax implications into account but did not offer a timeline. <\/p>\n
\u201cWe\u2019re talking to members of the legislature. We will be dealing with this,\u201d DeWine said. \u201cWe will, you know, follow the law.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"COLUMBUS, Ohio — The Ohio Supreme Court ordered the state to pay nursing homes up to $1 billion.…\n","protected":false},"author":2,"featured_media":429344,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":{"0":"post-429343","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/429343","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=429343"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/429343\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/429344"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=429343"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=429343"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=429343"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}