Complete Story
02/19/2026
Medicaid Director Details Impact of Federal H.R. 1; Mandamus Implementation Still Under Review
Ohio Medicaid Director Scott Partika briefed lawmakers this week on the wide-ranging impact of H.R. 1, the federal Medicaid reform law enacted in July 2025, outlining changes to eligibility rules, financing structures and program integrity requirements that will phase in over the next several years.
Testifying before a joint meeting of the House and Senate Medicaid committees, Partika said the law requires Ohio to implement several new eligibility policies, including six-month redeterminations for expansion adults and mandatory work and community engagement requirements beginning by the end of 2026. Approximately 70,000 Ohioans could be affected by the work requirements.
On the financing side, Partika said federal restrictions on provider taxes and state-directed payments will have longer-term budget implications. Ohio’s hospital franchise fee and managed care organization tax will face phased reductions, and state-directed payments will gradually move toward Medicare-equivalent limits.
He also warned that changes to the federal PERM audit process beginning in 2029 could expose Ohio to significant financial penalties if payment error rates exceed federal thresholds.
During the hearing, Rep. Tim Barhorst (R- Fort Loramie) asked about the Ohio Supreme Court’s recent mandamus ruling related to nursing facility rates and the Quality Incentive Program, noting he has received calls from nursing home providers seeking clarity.
Barhorst asked directly whether rates are being recalculated and when providers might expect distributions.
Partika acknowledged the volume of inquiries and said the department has been in close communication with nursing home associations since the ruling.
He stated ODM is conducting due diligence to balance the Supreme Court’s decision with the statutory language enacted by the General Assembly at the end of 2025 in House Bill 184. He indicated that the Department is working closely with Governor Mike DeWine and that the next step will likely involve discussions between the Governor and legislative leadership on how to proceed.
However, Partika said he could not provide a specific timeline for recalculated rates or distribution of back payments at this time.
Director Partika’s testimony and presentation can be found here.