06/12/2019

Senate Budget Further Boosts LTSS Funding

On Tuesday afternoon, the Senate Finance Committee released its first draft of HB 166, Ohio’s state budget for the SFY 2020-2021. The changes included further boosts to Assisted Living and PASSPORT funding, bringing the total increases to 5.1% over current funding levels. Furthermore, it further increased nursing home funding by $50 million, while maintaining the quality incentive program included in the House version. Also preserved was the additional funding for the Enhanced Community Living (ECL) program under PASSPORT.

Many of the House provisions related to managed care, hospitals and pharmacy management were repealed. Other sections repealed include:

• The requirement that managed care plans pay claims within 30 days and pay interest on late payments. Left intact were requirements for ODM to standardize the claim format for managed care plans.
• The prohibitions on prior authorization requirements for certain home health patients and referrals.
• The one-year time limit on managed care recoupments. Left intact were the requirements for plans to provide justification and detail for why recoupments were being made.

Several new programs were advanced by the Senate, including a Rural Healthcare Workforce Training and Retention Program and a Managed Care Claims Fund, which will consist of money that Medicaid MCOs pay to ODM in order for ODM to make payments to providers under the care management system that the organizations are unable to make due to systems issues.

LeadingAge Ohio is working to understand each of the provisions included in the budget and their impact on members. Any questions related to the budget may be directed to Susan Wallace, Director of Government Relations and Public Affairs, at swallace@leadingageohio.org.