Last week, the Ohio House of Representatives released its iteration of the biennial budget, outlining its priorities for the coming two years. The House was under additional pressure as the Office of Management and Budget estimated an additional $800 million shortfall that needed to be accommodated. The House successfully stripped $630 million from the executive budget levels, some of it at a cost to senior service providers.
Gov. Kasich’s final biennium budget was introduced in the House Finance Committee on February 8, 2017, HB 49 (Rep. Smith). While the House is now actively working to create its proposed changes, we wanted members to have a summary of the executive budget provisions impacting long term care providers that are included in the governor’s budget. As a reminder, the House is holding committee and standing subcommittee hearings on the operating appropriations bills. Testimony from Ohio Department of Medicaid (ODM), Ohio Department of Aging (ODA), Office of Health Transformation (OHT) are expected to occur the week of March 7. The House is expected to release its substitute bill in mid-April.
LeadingAge and the LeadingAge state affiliates (including LeadingAge Ohio) are working in conjunction with Pathway Health to provide tools to help members navigate through the Requirements of Participation for Phase I of the new Mega Rule.
LeadingAge and the LeadingAge state affiliates (including LeadingAge Ohio) are working in conjunction with Pathway Health to provide tools to help members navigate through the Requirements of Participation for Phase I of the new Mega Rule. The policies and tools, which will be available from the LeadingAge Ohio member/subscriber restricted website, have been designed for national distribution and comply with the CMS Mega Rule.
In early December, LeadingAge Ohio members joined their colleagues at three regional trainings on the new Requirements of Participation for nursing facilities. The trainings brought together industry experts Janet Feldkamp, Partner, Benesch, and Stephanie DeWeese, Quality & Regulatory Specialist - Long Term Care, LeadingAge Ohio, to work through the RoPs, one by one, providing helpful tips for implementation.
Yesterday afternoon, November 22, a federal trial court in Texas issued a nationwide preliminary injunction blocking the new FLSA salary regulations from going into effect on December 1. This means that, right now, the new regulations raising the salary threshold test for the white collar exemptions cannot be implemented by the U.S. Department of Labor (DOL).
Attention: Nursing Facility Providers
John Maynard, Program Integrity Director, Ohio Department of Medicaid (ODM) explained that ODM had completed the first wave of their “second look” of the 2011 post-payment claim reviews. Through this process ODM has reviewed 100% of the ICF/IID claims and the top 10% of the highest dollar amounts of nursing facility claims.
Preserving affordable senior housing is crucial in the face of increasing need. There are approximately 2,800 properties serving over 120,000 households headed by low-income seniors that are in great need of repairs and upgrades to meet the needs of their residents.
Revisions to State Operations Manual (SOM), Appendix PP - Revised Regulations and Tags
In the October 20 edition of The Source, we shared the potential impact on a specific piece of the new Rules of Participation slated to go into effect on November 28, 2016 for those communities who are Medicaid and/or Medicare providers.
The Centers for Medicare and Medicaid Services (CMS) issued the Final Rule: Medicare and Medicaid Programs: Reform of Requirements for Long-Term Care Facilities that was published in the Federal Register on Oct 4.
Centers for Medicare and Medicaid Services (CMS) published the final rules revising the nursing home requirements of participation on Tuesday, October 4, 2016. This rule represents the most significant changes to the delivery of nursing home care since OBRA ‘87.
Ohio Department of Medicaid (ODM) had provided clarification regarding the data entry required in Ohio Benefits when the Passport Administrative Agency (PAA) receives an ODM 9401 and the nursing facility resident does not require a level of care determination (based on OAC 5160-3-14 or the ODM Most Common Scenarios chart).
The Ohio Department of Medicaid (ODM) is providing the following guidance to nursing facilities and county department of job and family services (CDJFS) regarding the backlogged ODM 9401s not processed before Ohio Benefits went live on August 1.
The LeadingAge Ohio Annual Business Meeting will be held in conjunction with the upcoming 2016 Annual Conference and Trade Show, Stronger Together, on Friday, September 9, 2016 from 9:45 a.m. - 11:15 a.m. Hyatt Regency Columbus.
ODM will audit Medicaid election statements from all Ohio Hospices serving Medicaid patients beginning late August. In discussions with ODM, they expect this audit to take place through October 31, 2016.
Effective August 1, 2016, the Ohio Department of Medicaid has updated the form and process for completing the ODM 9401, previously the Facility CDJFS Transmittal. Depending on the type of request and/or update, nursing facilities (NF) will submit the ODM 9401 to either:
Providers are fast approaching the August deadline for implementation of the Disability Determination Redesign, which will shift Ohio Medicaid beneficiaries who previously had a spend-down amount to using Qualified Income Trusts, or QITs, to maintain or gain eligibility for Medicaid LTSS.
At 9:30 this morning we received word from Ohio Department of Medicaid (ODM) that the nursing facility rates were not able to be loaded to the MITS portal and therefore providers cannot access their rates through the MITS system.
On May 25, the Ohio state legislature passed a bill that will legalize the use of marijuana in particular forms to treat certain medical conditions. LeadingAge Ohio’s lobbying firm, Barnes and Thornburg, has prepared the following clarifications which will help providers understand the scope of the bill, and how it may impact their practice.
Stakeholder Group Seeks to Curtail Harm with Policy Change, Discussion
Columbus, Ohio—June 3, 2016—Yesterday, a group of lawmakers, researchers, experts in aging, and other stakeholders met in Columbus, Ohio for the first of a three-part conversation on the viability of Ohio’s system of financing and providing care for Ohioans as they enter their golden years.
NURSING FACILITY COST REPORT SENSITIVE INFORMATION
EVERY CERTIFIED NURSING FACILITY PROVIDER should be getting their quality point for the PELI instrument. Cheryl Guyman, Nursing Facility Policy Administrator, Ohio Department of Medicaid has confirmed that there is nothing in rule to prevent a facility from using MDS Section F:
Terry Moore from the Department of Medicaid (ODM) released final prices based upon updated inflation factors and a detail audit from Myers & Stuffer, LLP. The good news is all prices are higher than the originally projected prices released in December. If you use the SWA average Medicaid case mix of 2.6500, the increased prices average $1.53 per day.