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10/09/2019

ODM Shares Special Instructions for October Nursing Facility (NF) Room and Board Services Billing

The Ohio Department of Medicaid shared a memo on October 4, which describes the anticipated rate-setting for Nursing Facility Room and Board services to take effect on October 17. The changes result from a lesser-known change included in the biennial budget which removed the NF market basket update from the tax and $16.44 add-on portion of the rates. Originally scheduled to take effect in the next biennium, the effective date was vetoed by the Governor, resulting in this change taking place 90 days following the enrollment of the budget, on October 17, 2019.

According to the memo, the SNF market basket will be removed from the tax and $16.44 add-on components of the rates for the period of October 17, 2019 through and including December 31, 2019. All other components will remain the same. Similar to how NFs billed for the interim budget period in July, hospices who are billing on behalf of nursing facilities will need to submit two lines on claims for October. To review the full details, click here.

Nursing facilities have been encouraged to reach out to their hospice partners to inform them of this billing change for pass-through payments, but in case the nursing facilities forget to do so, LeadingAge Ohio wanted to make hospice providers aware of these changes.

Any questions related to this may be directed to Susan Wallace, Director of Government Relations and Public Affairs at swallace@leadingageohio.org.

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