03/17/2022

CMS approves relief for nursing facilities, hospices

Yesterday afternoon, the Ohio Department of Medicaid (ODM) reached out to LeadingAge Ohio to notify providers that the Centers for Medicare & Medicaid Services (CMS) had approved the state plan amendment (SPA) which would allow distribution of HB169 funds to nursing facilities, intermediate care facilities, and hospice programs. Funds have already been approved for distribution to DoDD waiver providers, PASSPORT and Ohio Home Care Waiver providers, as well as assisted living communities.

The funds will be distributed to nursing facilities and hospices as follows: 

• $225 million will be distributed to nursing facilities based on their Medicaid-certified bed count. $75 million will be distributed based on the quality incentive payment (QIP) methodology, on a “per point, per Medicaid day” basis. Previously, ODM had implied they would distribute the QIP funds based on a per-point, per-bed basis, but this is not the case.
• Hospices will receive $3.7 million distributed based on an estimated 10 percent of total Medicaid payments between November 1, 2020 and October 31, 2021.  CMS did not approve an alternative methodology for the remaining $19 million that were appropriated for hospices in HB169, since they were based on room and board payments for hospice patients residing in nursing facilities.

Before ODM can distribute the funds, it must promulgate an emergency rule to be approved by the Governor. It estimates that next week, it will be able to initiate the disbursement in the MITS system, and funds should be distributed the week of March 28. Any questions related to HB169 relief payments may be sent to Susan Wallace at swallace@leadingageohio.org.