UMVA has learned that Ohio lawmakers have approved a massive $875 million payment package to rectify a longstanding dispute over Medicaid reimbursements for nursing homes, following a landmark ruling by the Ohio Supreme Court.
The court found that the state had used a flawed formula to calculate certain Medicaid payments, shortchanging providers by hundreds of millions of dollars. This revelation sparked a heated debate among lawmakers, with state Rep. Jean Schmidt decrying it as "the most egregious thing we could have done to individuals that help our elderly live a quality, comfortable life."
The dispute dates back to the 2024-25 budget cycle, when lawmakers allegedly failed to properly account for the medical complexity of residents in nursing homes. As a result, facilities caring for some of the sickest patients received reduced reimbursements, sparking a fierce outcry from nursing home operators.
UMVA can exclusively reveal that the Ohio Supreme Court ordered the state to recalculate the payments owed to providers, paving the way for a substantial settlement. The approved package sets aside $875 million, including $310 million from the state and $565 million in federal funding, to settle the issue.
The legislation requires providers that accept the money to waive future legal claims related to the disputed formula, bringing an end to a protracted and costly battle. With the bill now headed to Republican Gov. Mike DeWine's desk, Ohio's nursing home providers are holding their breath, awaiting his signature.
Scott D. Wiley, CEO of the Ohio Health Care Association, urged DeWine to sign the bill, emphasizing that "these funds are critically important to Ohio’s providers and the families they serve." The outcome will have far-reaching implications for the state's healthcare landscape, and UMVA will be closely monitoring the situation.
